Provider Demographics
NPI:1588704266
Name:FEINBERG, LESLIE S (DC)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:S
Last Name:FEINBERG
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 527
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-0527
Mailing Address - Country:US
Mailing Address - Phone:541-567-0200
Mailing Address - Fax:541-567-1176
Practice Address - Street 1:633 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1969
Practice Address - Country:US
Practice Address - Phone:541-567-0200
Practice Address - Fax:541-567-1176
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT67601Medicare UPIN
OR108965Medicare ID - Type Unspecified