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NPI Code Detail

MEDICARE: MR. CHESTER DELFIN PT

MEDICARE: MR. CHESTER DELFIN PT
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
1225100000XPhysical Therapist6109OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255846309
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHESTER DELFIN PT
Provider Business Mailing Address
First Line : 3270 LIBERTY RD. S.
Second Line :
City : SALEM
State : OR
Zip : 97302
Country : US
Telephone Number : 503-371-0779
Fax Number : 503-371-0886
Provider Business Practice Location Address
First Line : 515 TAGGART DR NW STE 150
Second Line :
City : SALEM
State : OR
Zip : 97304-4149
Country : US
Telephone Number : 503-363-6770
Fax Number : 503-363-4789
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2017
Last Update Date : 08/29/2019

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