Provider Demographics
NPI:1063588630
Name:SKELTON, GEOFFREY K (DC)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:K
Last Name:SKELTON
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 8
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-0008
Mailing Address - Country:US
Mailing Address - Phone:503-656-1680
Mailing Address - Fax:
Practice Address - Street 1:15480 SE 82ND DR
Practice Address - Street 2:SUITE B
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9633
Practice Address - Country:US
Practice Address - Phone:503-656-1680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor