Provider Demographics
NPI:1538370184
Name:TACCOGNA, STEVEN FRANK (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:FRANK
Last Name:TACCOGNA
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:PO BOX 588
Mailing Address - Street 2:278 ROWE #203
Mailing Address - City:MANZANITA
Mailing Address - State:OR
Mailing Address - Zip Code:97130
Mailing Address - Country:US
Mailing Address - Phone:503-368-6050
Mailing Address - Fax:
Practice Address - Street 1:278 ROWE
Practice Address - Street 2:#201
Practice Address - City:WHEELER
Practice Address - State:OR
Practice Address - Zip Code:97147
Practice Address - Country:US
Practice Address - Phone:503-368-6050
Practice Address - Fax:503-368-7014
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000QGHDGMedicare ID - Type Unspecified
0000QGHDGMedicare UPIN