Healthcare Provider Details

I. General information

NPI: 1487948212
Provider Name (Legal Business Name): DELPLATO CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25500 SE STARK ST STE 201B
GRESHAM OR
97030-8328
US

IV. Provider business mailing address

25500 SE STARK ST STE 201B
GRESHAM OR
97030-8328
US

V. Phone/Fax

Practice location:
  • Phone: 503-667-9491
  • Fax:
Mailing address:
  • Phone: 503-667-9491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2820
License Number StateOR

VIII. Authorized Official

Name: DR. ELIZABETH DELPLATO
Title or Position: PRESIDENT
Credential: D.C.
Phone: 503-667-9491