Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 5129 | OR |
Y | 111NS0005X | Chiropractic Sports Physician | 5129 | OR |
NPI | 1366782344 |
---|---|
Provider Name | Dr. Dain P Cason |
First Address | Portland, OR 97219-4036 |
Second Address | Portland, OR 97219-4036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2013 |
Last Update Date | 27/02/2013 |