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General NPI Number Information
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NPI Number | 1164162020
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Entity Type | Organization
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Legal Business Name | TERRY YCASAS, DC, LLC
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 716 SE 11TH AVE
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City | PORTLAND
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State | OR
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Zip | 97214-2469
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Country | US
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Telephone | 503-866-4680
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Fax |
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Provider Business Mailing Address
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Address Line | 716 SE 11TH AVE
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City | PORTLAND
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State | OR
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Zip | 97214-2469
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Country | US
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Telephone | 503-866-4680
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRY YCASAS
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Credential | DC
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Telephone | 503-866-4680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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