Provider Demographics
NPI:1447497789
Name:RHUE, JONATHAN (DC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:RHUE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:BORING
Mailing Address - State:OR
Mailing Address - Zip Code:97009-0909
Mailing Address - Country:US
Mailing Address - Phone:503-668-5822
Mailing Address - Fax:503-668-3662
Practice Address - Street 1:437 NE MAIN ST
Practice Address - Street 2:
Practice Address - City:ESTACADA
Practice Address - State:OR
Practice Address - Zip Code:97023-8528
Practice Address - Country:US
Practice Address - Phone:503-630-4037
Practice Address - Fax:503-630-5636
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4059111N00000X
DEF1-0000731111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR181066OtherMEDICARE PTAN