Provider Demographics
NPI:1679896328
Name:DUNCAN CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:DUNCAN CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-853-4898
Mailing Address - Street 1:5821 SW COVENTRY PL
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-3355
Mailing Address - Country:US
Mailing Address - Phone:503-853-4898
Mailing Address - Fax:
Practice Address - Street 1:3300 SW HOCKEN AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2444
Practice Address - Country:US
Practice Address - Phone:503-526-8782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty