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NPI Code Detail

MEDICARE: SEAN O HERRIN D.C.

MEDICARE: SEAN O HERRIN 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
1111N00000XChiropractor273503OR

General Provider Information

NPI Number : 1164547774
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN O HERRIN D.C.
Provider Business Mailing Address
First Line : 6717 N ALTA AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97203-5418
Country : US
Telephone Number : 503-708-2047
Fax Number :
Provider Business Practice Location Address
First Line : 2330 NW FLANDERS ST STE 101
Second Line :
City : PORTLAND
State : OR
Zip : 97210-3400
Country : US
Telephone Number : 503-701-8766
Fax Number : 503-241-5484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 03/30/2011

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Directions to “ SEAN O HERRIN D.C.” Practice Location

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