Thomas Dutcher D.C., P.C. Inc.
Organization Active NPI Chiropractor · Damascus, OR
NPI 1164747762 · NPPES record last updated Jan 24, 2012
Key facts
- NPI
- 1164747762
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2563 (OR)
- Legal business name
- THOMAS DUTCHER D.C., P.C. INC.
- Practice address
- 14605 SE 202ND Ave
Damascus, OR 97089 - Phone
- (503) 658-2225
- Fax
- (503) 658-4554
- NPI assigned
- Apr 7, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Thomas Dale Dutcher, D.C.
- Title
- Owner
- Phone
- (503) 658-2225
Practitioners 2
-
Thomas Dale Dutcher, D.C.
-
Mari Ann Mains, L.M.T.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120124000000 | OR | Part B Supplier - Clinic/Group Practice | 0143497768 |
Receives reassigned benefits from 1 practitioner Practice locations: Damascus, OR |
National Provider Directory
Locations
14605 SE 202nd Ave
Damascus, OR 97089
Phone (503) 658-2225
20320 SE Highway 212
Damascus, OR 97089
Phone (503) 658-2225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2563 | OR | Yes |
Addresses
Primary practice location
14605 SE 202ND Ave
Damascus, OR 97089
Mailing address
14605 SE 202ND Ave
Damascus, OR 97089
Phone (503) 658-2225
Other names
- Sunrise Chiropractic
Other providers in Damascus, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.