DR. TREVOR STANLEY DOUGLASS DC CCSP MPH NPI 1255420139

NPI Information

NPI: 1255420139
Provider Name: DR. TREVOR STANLEY DOUGLASS, DC, CCSP, MPH
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
462 17TH ST NE
SALEM, OR
ZIP 97301
Phone: (971) 209-2774
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DR. Trevor Stanley Douglass, DC, CCSP, MPH is a chiropractor in Salem, OR. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DR. Trevor Stanley Douglass, DC, CCSP, MPH NPI is 1255420139. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

462 17TH ST NE
SALEM, OR
ZIP 97301-223
Phone: (971) 209-2774

The enumeration date for this NPI number is 10/11/2006 and was last updated on 12/17/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111NS0005X	Chiropractor	Sports Physician	273119	OREGON	No
2	111N00000X	Chiropractor		273119	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	931265398	MEDICARE UPIN	OREGON
2	R103432	MEDICARE ID-TYPE UNSPECIFIED	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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