Provider Demographics
NPI:1043749658
Name:DPRCHIRO LLC
Entity Type:Organization
Organization Name:DPRCHIRO LLC
Other - Org Name:CHIROPRACTIC CONNECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:P
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LMT
Authorized Official - Phone:971-354-6916
Mailing Address - Street 1:4330 SW 188TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97078-1517
Mailing Address - Country:US
Mailing Address - Phone:971-354-6916
Mailing Address - Fax:971-228-5438
Practice Address - Street 1:8196 SW HALL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-4676
Practice Address - Country:US
Practice Address - Phone:971-354-6916
Practice Address - Fax:971-228-5438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5768111N00000X
OR22330225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty