Provider Demographics
NPI:1083121859
Name:MUEHLEIP, MAXWELL ELLIOTT (MS, DC)
Entity Type:Individual
Prefix:DR
First Name:MAXWELL
Middle Name:ELLIOTT
Last Name:MUEHLEIP
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 SW MARLOW AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5105
Mailing Address - Country:US
Mailing Address - Phone:034-699-8185
Mailing Address - Fax:503-379-0967
Practice Address - Street 1:1675 SW MARLOW AVE STE 301
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5105
Practice Address - Country:US
Practice Address - Phone:503-469-9818
Practice Address - Fax:503-379-0967
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5831111NN1001X, 111N00000X
133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No133N00000XDietary & Nutritional Service ProvidersNutritionist