Provider Demographics
NPI:1730231846
Name:PLEWES, WILLIAM KENNETH (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KENNETH
Last Name:PLEWES
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 1:238 SE WASHINGTON ST
Mailing Address - Street 2:# B
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4279
Mailing Address - Country:US
Mailing Address - Phone:503-648-1088
Mailing Address - Fax:503-648-0748
Practice Address - Street 1:238 SE WASHINGTON ST
Practice Address - Street 2:# B
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4279
Practice Address - Country:US
Practice Address - Phone:503-648-1088
Practice Address - Fax:503-648-0748
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 1677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR102368OtherCLINIC MEDICARE NUMBER
OR0147110OtherWASH. ST. LABOR AND IND.
OR023051001OtherBLUE CROSS
OR0147110OtherWASH. ST. LABOR AND IND.
ORT68018Medicare UPIN