Healthcare Provider Details

I. General information

NPI: 1598863888
Provider Name (Legal Business Name): VERONICA ESAGUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21860 WILLAMETTE DR
WEST LINN OR
97068-3256
US

IV. Provider business mailing address

8852 SW ASHFORD ST
TIGARD OR
97224-5240
US

V. Phone/Fax

Practice location:
  • Phone: 503-650-2394
  • Fax: 503-905-6180
Mailing address:
  • Phone: 503-913-6006
  • Fax: 503-905-6180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number273154
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: