Individual
DR. PETER MICHAEL OVERVOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2106 NE 47TH AVE, PORTLAND, OR 97213-2064
(503) 282-7581
Mailing address
11127 SE ROLLING HILLS LN, HAPPY VALLEY, OR 97086-7040
(503) 698-7570
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1540
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
228-6554
ODS
OR
01
—
5-2585
BLUE CROSS / BLUE SHIELD
OR
Enumeration date
05/02/2006
Last updated
09/29/2010
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