Dr. Charles Richard Hathaway
Chiropractor Orthopedic Specialist
10011 Se Division St Suite 205
Portland
, Oregon 97266-1351
Dr. Charles Richard Hathaway
Chiropractor Orthopedic Specialist
10011 Se Division St Suite 205
Portland
, Oregon 97266-1351
(503) 256-2493
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About
Features
Specialties
- Chiropractor Orthopedic Specialist
Languages spoken
- English
Location
First Address
- Dr. Charles Richard Hathaway
- 10011 Se Division St Suite 209
- Portland, OR
- Zip : 97266-1351
- Fax : (503) 256-2493
- Phone : (503) 256-2654
Second Address
- Dr. Charles Richard Hathaway
- 10011 Se Division St Suite 205
- Portland, OR
- Zip : 97266-1351
- Fax : (503) 256-2493
- Phone : (503) 256-2654
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NX0800X | Chiropractor Orthopedic Specialist | 27-1248 | OR |
National Provider Identifier
| NPI | 1093896631 |
|---|---|
| Provider Name | Dr. Charles Richard Hathaway |
| First Address | Portland, OR 97266-1351 |
| Second Address | Portland, OR 97266-1351 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/10/2006 |
| Last Update Date | 11/03/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 20-1718201 | TAX ID (01) | OR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.