Provider Demographics
NPI:1306113451
Name:SAJOVIC, JORDAN EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:EDWARD
Last Name:SAJOVIC
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 1:2150 COMMERCIAL ST SE SUITE 10
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302
Mailing Address - Country:US
Mailing Address - Phone:971-707-4706
Mailing Address - Fax:971-707-4705
Practice Address - Street 1:2150 COMMERCIAL ST SE SUITE 10
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302
Practice Address - Country:US
Practice Address - Phone:971-707-4706
Practice Address - Fax:971-707-4705
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor