Individual
TRISTAN SANTIAGO MACEIRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5802 SE POWELL BLVD, PORTLAND, OR 97206-2826
(503) 714-3701
Mailing address
2712 NE 92ND AVE, PORTLAND, OR 97220-5364
(512) 695-0971
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
6256
OR
111NN0400X
Neurology Chiropractor
Primary
6256
OR
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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