Organization
MILWAUKIE CHIROPRACTIC - DR. JESSE BROCKEY LLC
Active
Other names
Columbia Pacific Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE OWEN BROCKEY D.C. (OWNER/CHIROPRACTOR)
(503) 861-1661
Entity
Organization
Contact information
Practice address
679 E HARBOR DR, #140, WARRENTON, OR 97146-9717
(503) 861-1661
(503) 861-0254
Mailing address
PO BOX 576, WARRENTON, OR 97146-0576
(503) 861-1661
(503) 861-0254
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5008
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R172616
MEDICARE PTAN
OR
Enumeration date
05/24/2016
Last updated
05/24/2016
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