Provider Demographics
NPI:1528281284
Name:CARDONA, JULIO CESAR JR (DC)
Entity type:Individual
Prefix:DR
First Name:JULIO
Middle Name:CESAR
Last Name:CARDONA
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14335 SW ALLEN BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4463
Mailing Address - Country:US
Mailing Address - Phone:760-716-5373
Mailing Address - Fax:503-601-0543
Practice Address - Street 1:14335 SW ALLEN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4463
Practice Address - Country:US
Practice Address - Phone:503-352-0265
Practice Address - Fax:503-601-0543
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR713673111N00000X
WACH00034621111N00000X
CADC27397111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor