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General NPI Number Information
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NPI Number | 1861957482
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Entity Type | Individual
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Provider Name | ALLISON GUYN CHAMPAGNE DC
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Gender | Female
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Dates
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Enumeration Date | 02/07/2019
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 3537 N WILLIAMS AVE STE 202A
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City | PORTLAND
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State | OR
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Zip | 97227-1437
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Country | US
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Telephone | 971-801-8848
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Fax | 971-606-2152
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Provider Business Mailing Address
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Address Line | 1656 REED AVE APT 6
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City | SAN DIEGO
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State | CA
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Zip | 92109-5492
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Country | US
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Telephone | 503-528-6019
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5972
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 35220
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License Number State | CA
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