Healthcare Provider Details

I. General information

NPI: 1295793255
Provider Name (Legal Business Name): PETER VUKY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 NE SANDY BLVD
PORTLAND OR
97213-7100
US

IV. Provider business mailing address

8040 NE SANDY BLVD
PORTLAND OR
97213-7100
US

V. Phone/Fax

Practice location:
  • Phone: 503-249-7737
  • Fax: 503-249-9207
Mailing address:
  • Phone: 503-249-7737
  • Fax: 503-249-9207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3185
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: