Healthcare Provider Details

I. General information

NPI: 1952524951
Provider Name (Legal Business Name): MICHELLE K CHARD DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 E POWELL BLVD
GRESHAM OR
97030-7617
US

IV. Provider business mailing address

501 NE HOOD AVE, STE 205
GRESHAM OR
97030
US

V. Phone/Fax

Practice location:
  • Phone: 503-669-9495
  • Fax: 503-669-8257
Mailing address:
  • Phone: 503-674-7894
  • Fax: 503-674-7899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number71 3725
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: