MEDICARE: DR. LYNN M WITTE 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	27-2367	OR

Other Identifiers

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

General Provider Information

NPI Number	:	1841480597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN M WITTE DC

Provider Business Mailing Address
First Line	:	9860 SW HALL BLVD
Second Line	:	SUITE C3
City	:	TIGARD
State	:	OR
Zip	:	97223-8896
Country	:	US
Telephone Number	:	503-246-8648
Fax Number	:

Provider Business Practice Location Address
First Line	:	9860 SW HALL BLVD
Second Line	:	SUITE C3
City	:	TIGARD
State	:	OR
Zip	:	97223-8896
Country	:	US
Telephone Number	:	503-246-8648
Fax Number	:

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

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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