Provider Demographics
NPI:1598579559
Name:URBACH, JARED FLOYD (DC)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:FLOYD
Last Name:URBACH
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 1:23775 SW STONEHAVEN ST
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-7078
Mailing Address - Country:US
Mailing Address - Phone:541-701-7828
Mailing Address - Fax:
Practice Address - Street 1:8905 SW NIMBUS AVE STE 140
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7103
Practice Address - Country:US
Practice Address - Phone:503-512-9591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor