Provider Demographics
NPI:1275892267
Name:JOURNEY THROUGH HEALING CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:JOURNEY THROUGH HEALING CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HUBBELL-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-480-0200
Mailing Address - Street 1:830 SAGINAW ST S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4122
Mailing Address - Country:US
Mailing Address - Phone:503-480-0200
Mailing Address - Fax:503-480-0203
Practice Address - Street 1:830 SAGINAW ST S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4122
Practice Address - Country:US
Practice Address - Phone:503-480-0200
Practice Address - Fax:503-480-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR157028OtherPTAN