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Individual

DR. SHANE HARRISON OTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2230 NW PETTYGROVE ST, SUITE 110, PORTLAND, OR 97210-2659
(503) 224-4804
(503) 224-7391
Mailing address
2230 NW PETTYGROVE ST, SUITE 110, PORTLAND, OR 97210-2659
(503) 224-4804
(503) 224-7391

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5091
OR

Other

Enumeration date
11/30/2012
Last updated
11/30/2012
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