MEDICARE: CYNDI ROZELLA MYERS DC

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	71 3748	OR

General Provider Information

NPI Number	:	1790983864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNDI ROZELLA MYERS DC

Provider Business Mailing Address
First Line	:	655 D ST
Second Line	:
City	:	WASHOUGAL
State	:	WA
Zip	:	98671-2155
Country	:	US
Telephone Number	:	360-907-1416
Fax Number	:

Provider Business Practice Location Address
First Line	:	9955 SE WASHINGTON ST
Second Line	:	STE 320 #6
City	:	PORTLAND
State	:	OR
Zip	:	97216-2439
Country	:	US
Telephone Number	:	503-252-8818
Fax Number	:

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	07/12/2007

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