MEDICARE: DR. BRIAN DENIS MCHALE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	272916	OR
2	111NN0400X	Neurology Chiropractor	272916	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	931184440	OTHER	OR	TAX ID
2	0104061	OTHER	OR	WASHINGTON ST WORK COMP

General Provider Information

NPI Number	:	1053411041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN DENIS MCHALE D.C.

Provider Business Mailing Address
First Line	:	707 7TH ST
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-2346
Country	:	US
Telephone Number	:	503-659-5029
Fax Number	:	503-652-1886

Provider Business Practice Location Address
First Line	:	707 7TH ST
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-2346
Country	:	US
Telephone Number	:	503-659-5029
Fax Number	:	503-652-1886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	11/01/2013

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