Provider Demographics
NPI:1124348560
Name:DORSEY, MARCUS J (DC)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:J
Last Name:DORSEY
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 1:4317 NE TILLAMOOK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-1315
Mailing Address - Country:US
Mailing Address - Phone:503-493-9730
Mailing Address - Fax:503-493-1642
Practice Address - Street 1:4317 NE TILLAMOOK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1315
Practice Address - Country:US
Practice Address - Phone:503-493-9730
Practice Address - Fax:503-493-1642
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2011-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR29677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor