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General NPI Number Information
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NPI Number | 1225384761
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Entity Type | Organization
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Legal Business Name | CLATSKANIE FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 50 NW 4TH ST.
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City | CLATSKANIE
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State | OR
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Zip | 97016-1415
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Country | US
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Telephone | 503-728-4978
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Fax | 509-728-9021
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Provider Business Mailing Address
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Address Line | 50 NW 4TH ST.
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City | CLATSKANIE
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State | OR
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Zip | 97016-1415
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Country | US
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Telephone | 503-728-4978
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Fax | 503-728-9021
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. SHEILA MARIE LANDIS-PEIRAVI
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Credential | D.C.
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Telephone | 503-728-4978
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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 |
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License Number State | OR
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