Healthcare Provider Details

I. General information

NPI: 1568527315
Provider Name (Legal Business Name): JAMES ROBERT MARION D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SE 223RD AVE SUITE 206
GRESHAM OR
97030-7454
US

IV. Provider business mailing address

269 NE MILNE RD
HILLSBORO OR
97124-4309
US

V. Phone/Fax

Practice location:
  • Phone: 503-953-2706
  • Fax: 503-661-1033
Mailing address:
  • Phone: 503-953-2706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3564
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: