Provider Demographics
NPI:1265649586
Name:HOPKINS CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:HOPKINS CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-543-8605
Mailing Address - Street 1:51669 S. COLUMBIA RIVER HWY.
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056
Mailing Address - Country:US
Mailing Address - Phone:503-543-8605
Mailing Address - Fax:503-210-8166
Practice Address - Street 1:51669 S. COLUMBIA RIVER HWY.
Practice Address - Street 2:SUITE 130
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056
Practice Address - Country:US
Practice Address - Phone:503-543-8605
Practice Address - Fax:503-210-8166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR133038Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER