Provider Demographics
NPI:1871708164
Name:ZYWECK, CHRISTIAN RUBEN (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:RUBEN
Last Name:ZYWECK
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 1:11722 SW 128TH AVE
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-7881
Mailing Address - Country:US
Mailing Address - Phone:503-550-3850
Mailing Address - Fax:
Practice Address - Street 1:25700 SW ARGYLE AVE
Practice Address - Street 2:UNIT C
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-5799
Practice Address - Country:US
Practice Address - Phone:503-550-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3517111N00000X
PR297111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor