Individual
DMITRIY TUPIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
11679 NE GLISAN ST, PORTLAND, OR 97220-2264
(971) 373-8257
(971) 373-8259
Mailing address
11679 NE GLISAN ST, PORTLAND, OR 97220-2264
(971) 373-8257
(971) 373-8259
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5722
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500742574
—
OR
Enumeration date
05/03/2016
Last updated
05/13/2019
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