Healthcare Provider Details

I. General information

NPI: 1023081155
Provider Name (Legal Business Name): MARK J DEN HARTOG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E 4TH AVE
EUGENE OR
97401-2429
US

IV. Provider business mailing address

225 E 4TH AVE
EUGENE OR
97401-2429
US

V. Phone/Fax

Practice location:
  • Phone: 541-762-4807
  • Fax:
Mailing address:
  • Phone: 541-762-4807
  • Fax: 541-795-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6485
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number60741817
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: