Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 3641 | OR |
NPI | 1689745234 |
---|---|
Provider Name | Viktor A Palchikovskiy |
First Address | Portland, OR 97213-6336 |
Second Address | Portland, OR 97213-6336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |