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NPI 1154669711

NPI 1154669711 : SOLON CHASE GENTRY D.C. : PORTLAND, OR

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General NPI Number Information
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    NPI Number           |    1154669711
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    Entity Type          |    Individual 
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    Provider Name        |    SOLON CHASE GENTRY D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/16/2013
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    Last Update Date     |    08/06/2025
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Provider Practice Location Address
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    Address Line         |    12766 SE STARK ST 
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    City                 |    PORTLAND
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    State                |    OR
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    Zip                  |    97233-1539
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    Country              |    US
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    Telephone            |    503-232-2933
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    Fax                  |    971-271-7054
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Provider Business Mailing Address
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    Address Line         |    12766 SE STARK ST 
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    City                 |    PORTLAND
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    State                |    OR
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    Zip                  |    97233-1539
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    Country              |    US
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    Telephone            |    503-232-2933
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    Fax                  |    971-271-7054
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111NR0400X
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    Taxonomy Name        |    Rehabilitation Chiropractor
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    License Number       |    5078
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    License Number State |    OR
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