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General NPI Number Information
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NPI Number | 1275736126
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Entity Type | Organization
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Legal Business Name | REDMOND WELLNESS AND CHIROPRACTIC
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1655 SW HIGHLAND AVE SUITE 3
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City | REDMOND
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State | OR
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Zip | 97756-2558
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Country | US
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Telephone | 541-923-2019
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Fax | 541-923-4636
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Provider Business Mailing Address
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Address Line | 1655 SW HIGHLAND AVE SUITE 3
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City | REDMOND
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State | OR
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Zip | 97756-2558
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Country | US
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Telephone | 541-923-2019
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Fax | 541-923-4636
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID CHARLES HERRIN
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Credential | D.C.
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Telephone | 541-923-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 71 3734
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License Number State | OR
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