Provider Demographics
NPI:1053411041
Name:MCHALE, BRIAN DENIS (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DENIS
Last Name:MCHALE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-2346
Mailing Address - Country:US
Mailing Address - Phone:503-659-5029
Mailing Address - Fax:503-652-1886
Practice Address - Street 1:707 7TH ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2346
Practice Address - Country:US
Practice Address - Phone:503-659-5029
Practice Address - Fax:503-652-1886
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272916111N00000X, 111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR931184440OtherTAX ID
OR0104061OtherWASHINGTON ST WORK COMP
ORR0000QGHFGMedicare ID - Type Unspecified
OR0104061OtherWASHINGTON ST WORK COMP