Provider Demographics
NPI:1871752980
Name:VOGEL, VALERIE LYNN (D C)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:LYNN
Last Name:VOGEL
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9035 SW RAMBLER LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-7197
Mailing Address - Country:US
Mailing Address - Phone:503-351-1424
Mailing Address - Fax:
Practice Address - Street 1:3644 SW TROY ST STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1662
Practice Address - Country:US
Practice Address - Phone:503-351-1424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-2011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR000QGDVVMedicare UPIN