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General NPI Number Information
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NPI Number | 1700069176
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Entity Type | Organization
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Legal Business Name | JANINE M. MACDONALD, D.C., P.C.
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Dates
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Enumeration Date | 12/08/2007
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Last Update Date | 12/08/2007
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Provider Practice Location Address
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Address Line | 4562 SW 103RD AVE
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City | BEAVERTON
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State | OR
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Zip | 97005-3208
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Country | US
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Telephone | 503-574-3395
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Fax | 503-574-3395
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Provider Business Mailing Address
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Address Line | 4562 SW 103RD AVE
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City | BEAVERTON
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State | OR
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Zip | 97005-3208
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Country | US
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Telephone | 503-574-3395
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Fax | 503-574-3395
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JANINE M. MACDONALD, DC
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Credential | D.C.
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Telephone | 503-574-3395
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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 | 29-2909
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License Number State | OR
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