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Individual

DR. TREVOR STANLEY DOUGLASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC, CCSP, MPH

Contact information

Practice address
462 17TH ST NE, SALEM, OR 97301-4223
(971) 209-2774
Mailing address
1215 BARNES AVE SE, SALEM, OR 97306-1539
(971) 209-2774

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
273119
OR
111NS0005X
Sports Physician Chiropractor
273119
OR

Other

Enumeration date
10/11/2006
Last updated
12/17/2012
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