Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4013 | OR |
N | 111NN0400X | Neurology | 4013 | OR |
N | 111NN1001X | Nutrition | 4013 | OR |
N | 111NP0017X | Pediatric Chiropractor | 4013 | OR |
N | 111NR0200X | Radiology | 4013 | OR |
N | 213ER0200X | Radiology | 4013 | OR |
N | 111NR0400X | Rehabilitation Chiropractor | 4013 | OR |
N | 111NS0005X | Chiropractic Sports Physician | 4013 | OR |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 4013 | OR |
NPI | 1003132408 |
---|---|
Provider Name | Dr. Daniel Antonio Lujan |
First Address | Portland, OR 97239-4260 |
Second Address | Portland, OR 97239-4260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2010 |
Last Update Date | 12/04/2010 |