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Individual

MR. GARY JANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
22021 SW SHERWOOD BLVD, SHERWOOD, OR 97140-9327
(503) 625-2290
(503) 625-6297
Mailing address
PO BOX 550, SHERWOOD, OR 97140-0550
(503) 625-2290
(503) 625-6297

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27-1755
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112050
KAISER
OR
05
291856
OR
Enumeration date
05/23/2006
Last updated
05/08/2008
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