Healthcare Provider Details

I. General information

NPI: 1508037045
Provider Name (Legal Business Name): DYSON ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2303 E BURNSIDE ST
PORTLAND OR
97214-1655
US

IV. Provider business mailing address

2303 E BURNSIDE ST
PORTLAND OR
97214-1655
US

V. Phone/Fax

Practice location:
  • Phone: 503-287-7733
  • Fax: 503-281-7703
Mailing address:
  • Phone: 503-287-7733
  • Fax: 503-281-7703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2224
License Number StateOR

VIII. Authorized Official

Name: GAIL KARVONEN
Title or Position: MANAGING CHIROPRACTIC PHYSICIAN
Credential: DC
Phone: 503-287-7733