Provider Demographics
NPI:1194901710
Name:SNODGRASS, NOEL (DC)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:SNODGRASS
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 1:1220 SW MORRISON ST STE 900
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2228
Mailing Address - Country:US
Mailing Address - Phone:503-213-3745
Mailing Address - Fax:503-213-3745
Practice Address - Street 1:1220 SW MORRISON ST STE 900
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2228
Practice Address - Country:US
Practice Address - Phone:503-213-3745
Practice Address - Fax:503-213-3745
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor