Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 18760 | CA |
N | 111N00000X | Chiropractor | 3484 | OR |
N | 111NR0200X | Radiology | 18760 | CA |
N | 213ER0200X | Radiology | 18760 | CA |
Y | 111NR0200X | Radiology | 3484 | OR |
Y | 213ER0200X | Radiology | 3484 | OR |
NPI | 1043341167 |
---|---|
Provider Name | Dr. Deborah Ann Cherachanko |
First Address | Tualatin, OR 97062-8876 |
Second Address | Tualatin, OR 97062-8876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 14/09/2010 |