Healthcare Provider Details

I. General information

NPI: 1124539358
Provider Name (Legal Business Name): MARIA DORSKI DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2017
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90971 S WILLAMETTE ST
COBURG OR
97408
US

IV. Provider business mailing address

PO BOX 81
SPRINGFIELD OR
97477-0005
US

V. Phone/Fax

Practice location:
  • Phone: 833-628-5433
  • Fax: 833-628-5433
Mailing address:
  • Phone: 419-370-9257
  • Fax: 833-628-5433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5937
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number13631
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: