Active Wellness Chiropractic,pc
Chiropractor in Portland, OR. Organization (NPI-2).
NPI number1033518600
StatusActive
Last updated in NPPESAug 19, 2014
Details
- NPI
- 1033518600
- Entity type
- Organization (NPI-2)
- Legal business name
- Active Wellness Chiropractic,pc
- Organization subpart
- No
- Enumeration date
- Aug 19, 2014
- Last updated
- Aug 19, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 3632 | OR | Yes |
Practice location
1815 Sw Marlow AveSuite 206
Portland, OR 97225-5185
Phone 503-789-1014 · Fax 877-985-9111
Mailing address
1815 Sw Marlow AveSuite 206
Portland, OR 97225-5185
Phone 503-789-1014 · Fax 877-985-9111
Authorized official
Megan Dejana
Ceo
5037891014
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