Healthcare Provider Details

I. General information

NPI: 1255377792
Provider Name (Legal Business Name): MAREECHI DUVVURI DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2953 SE TURNER CREEK DR
HILLSBORO OR
97123-7944
US

IV. Provider business mailing address

2953 SE TURNER CREEK DR
HILLSBORO OR
97123-7944
US

V. Phone/Fax

Practice location:
  • Phone: 503-803-4564
  • Fax: 503-648-6076
Mailing address:
  • Phone: 503-803-4564
  • Fax: 503-648-6076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number273428
License Number StateOR

VIII. Authorized Official

Name: DR. MAREECHI DUVVURI
Title or Position: PRESIDENT
Credential: D.C.
Phone: 503-803-4564