Provider Demographics
NPI:1215077680
Name:HALL, JOSEPH ROCKWELL (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ROCKWELL
Last Name:HALL
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 1:22365 SW MANDAN DR
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-7371
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13599 SW PACIFIC HWY
Practice Address - Street 2:SUITE E
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-4801
Practice Address - Country:US
Practice Address - Phone:503-598-0999
Practice Address - Fax:503-598-7474
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000QGHKBMedicare ID - Type Unspecified