Provider Demographics
NPI:1891862223
Name:SEARS, MICHAEL S (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:SEARS
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 1:2609 NW THURMAN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2202
Mailing Address - Country:US
Mailing Address - Phone:503-225-0255
Mailing Address - Fax:503-652-5690
Practice Address - Street 1:2609 NW THURMAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2202
Practice Address - Country:US
Practice Address - Phone:503-225-0255
Practice Address - Fax:503-652-5690
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 1939111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation