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Individual

DR. MICHAEL D RAEBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C, CCSP

Contact information

Practice address
2064 N KILLINGSWORTH ST, PORTLAND, OR 97217-4439
(503) 719-7742
(503) 719-7571
Mailing address
2064 N. KILLLINGSWORTH ST, PORTLAND, OR 97217-4439
(503) 719-7742
(503) 719-7571

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
273652
OR

Other

Enumeration date
06/04/2007
Last updated
08/04/2010
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