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General NPI Number Information
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NPI Number | 1023360245
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Entity Type | Organization
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Legal Business Name | NW FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 1797 LANSING AVE NE
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City | SALEM
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State | OR
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Zip | 97301-8732
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Country | US
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Telephone | 503-391-9112
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Fax |
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Provider Business Mailing Address
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Address Line | 1797 LANSING AVE NE
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City | SALEM
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State | OR
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Zip | 97301-8732
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Country | US
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Telephone | 503-391-9112
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW ISAKSEN
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Credential | DC
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Telephone | 503-391-9112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3961
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License Number State | OR
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