Organization
SOURCE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C MCCALL DC (OWNER)
(503) 200-5778
Entity
Organization
Contact information
Practice address
15455 NW GREENBRIER PKWY, SUITE #150, BEAVERTON, OR 97006-7374
(503) 200-5778
Mailing address
15455 NW GREENBRIER PKWY, SUITE 150, BEAVERTON, OR 97006-5766
(503) 200-5778
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
273236
OR
111N00000X
Chiropractor
5794
OR
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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