Trevor Stanley Douglass, DC, CCSP, MPH

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

273119 Issued in OR

Practice address

462 17TH St NE
Salem, OR 97301-4223

Phone

(971) 209-2774

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1255420139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 BARNES AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973061539",
            "telephone_number": "971-209-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 17TH ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014223",
            "telephone_number": "971-209-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "TREVOR",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DC, CCSP, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273119",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OR",
            "license": "273119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas J. Schubert,D.C., P.C.
• Douglas Whitehead MD PC
• Jeneane Douglas, LPTA, C-SLPA, B.S.
• Scott Patrick Douglas, DPT
• Janelle Lee Douglass
• Doulas of Salem, LLC
• Volodymyr Y. Dovhyy, MD
• Madison Dow, M.S., CCC-SLP
• Marla Dow, MA LPC
• Roger Charles Dow, DMD

• Chiropractor in Salem, OR
• Providers in Salem, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.