Provider Demographics
NPI:1306295209
Name:ECONOMOU, GEORGE (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:ECONOMOU
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 1:403 SIEVERKROPP DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031
Mailing Address - Country:US
Mailing Address - Phone:760-402-4547
Mailing Address - Fax:
Practice Address - Street 1:1808 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1686
Practice Address - Country:US
Practice Address - Phone:541-386-2025
Practice Address - Fax:541-508-5208
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor