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General NPI Number Information
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NPI Number | 1952931321
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Entity Type | Individual
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Provider Name | MYLES SINCLAIR DC, MS, BS
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Gender | Male
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Dates
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Enumeration Date | 01/24/2020
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 2100 SE LAKE RD STE 1
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City | PORTLAND
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State | OR
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Zip | 97222-7759
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Country | US
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Telephone | 503-344-6711
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Fax |
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Provider Business Mailing Address
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Address Line | 4108 N HAIGHT AVE
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City | PORTLAND
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State | OR
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Zip | 97217-2920
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Country | US
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Telephone | 503-438-6126
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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 | 6060
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License Number State | OR
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