Healthcare Provider Details

I. General information

NPI: 1912494048
Provider Name (Legal Business Name): ADAMO MAZZAFERRO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2018
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 SW HIGHLAND AVE STE 6
REDMOND OR
97756-2558
US

IV. Provider business mailing address

1655 SW HIGHLAND AVE STE 6
REDMOND OR
97756-2558
US

V. Phone/Fax

Practice location:
  • Phone: 541-923-2019
  • Fax:
Mailing address:
  • Phone: 707-721-7018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60845720
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: