Provider Demographics
NPI:1770742991
Name:STEPHEN SALAZ, DC, PC
Entity type:Organization
Organization Name:STEPHEN SALAZ, DC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-492-6851
Mailing Address - Street 1:24595 SE STARK ST
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-3390
Mailing Address - Country:US
Mailing Address - Phone:503-492-6851
Mailing Address - Fax:503-492-8567
Practice Address - Street 1:24595 SE STARK ST
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-3390
Practice Address - Country:US
Practice Address - Phone:503-492-6851
Practice Address - Fax:503-492-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty