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Individual

DR. JEFFERY WALTER BAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
4630 RIVER RD N, SUITE A, KEIZER, OR 97303-4648
(503) 304-2225
(503) 304-2226
Mailing address
4630 RIVER RD N, SUITE A, KEIZER, OR 97303-4648
(503) 304-2225
(503) 304-2226

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
272556
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
68-0534396
FEDERAL TAX ID
OR
Enumeration date
12/28/2006
Last updated
06/12/2014
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