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Individual

DR. MARY H ZEGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
818 W 6TH ST STE 2, THE DALLES, OR 97058-1147
(541) 298-1404
Mailing address
PO BOX 1157, HOOD RIVER, OR 97031-0074
(541) 386-5925

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 2608
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
084004000
BLUE CROSS
OR
01
54573
WA ST DEPT OF LABOR & IND
OR
01
93-1022799
TAX IDENTIFICATION NUMBER
OR
01
U-44021
PACC
OR
Enumeration date
12/17/2006
Last updated
09/07/2010
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