Provider Demographics
NPI:1861296238
Name:CALDERON, NATHALIA (DC)
Entity type:Individual
Prefix:
First Name:NATHALIA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13375 SW HAWKS BEARD ST APT 226
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-1991
Mailing Address - Country:US
Mailing Address - Phone:818-518-6077
Mailing Address - Fax:
Practice Address - Street 1:3424 PACIFIC AVE STE B
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2093
Practice Address - Country:US
Practice Address - Phone:818-518-6077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6425111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor