Healthcare Provider Details

I. General information

NPI: 1326213646
Provider Name (Legal Business Name): ANDREW ZUREK D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16611 NE RUSSELL STREET #122
PORTLAND OR
97230-5900
US

IV. Provider business mailing address

PO BOX 20833
PORTLAND OR
97230-5900
US

V. Phone/Fax

Practice location:
  • Phone: 503-888-4597
  • Fax:
Mailing address:
  • Phone: 503-888-4597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number3823
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: