Provider Demographics
NPI:1861606857
Name:WARNER, JAMES K (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:K
Last Name:WARNER
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 1:4163 CHERRY AVE NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-4857
Mailing Address - Country:US
Mailing Address - Phone:503-390-1144
Mailing Address - Fax:503-390-1146
Practice Address - Street 1:4163 CHERRY AVE NE
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-4857
Practice Address - Country:US
Practice Address - Phone:503-390-1144
Practice Address - Fax:503-390-1146
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000QGCDNMedicare ID - Type Unspecified