Individual
DR. MARY ANN TACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
901 BRUTSCHER ST, STE 210, NEWBERG, OR 97132-6095
(503) 537-2052
(503) 538-8315
Mailing address
901 BRUTSCHER ST, STE 210, NEWBERG, OR 97132-6095
(503) 537-2052
(503) 538-8315
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 2863
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274833
—
OR
Enumeration date
09/17/2006
Last updated
06/19/2020
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