Provider Demographics
NPI:1306019500
Name:RINGSAGE CHIROPRACTIC AND SPORTS INJURY CLINIC P.C.
Entity Type:Organization
Organization Name:RINGSAGE CHIROPRACTIC AND SPORTS INJURY CLINIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDAL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RINGSAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-649-7373
Mailing Address - Street 1:3595 SW 170TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5018
Mailing Address - Country:US
Mailing Address - Phone:503-649-7373
Mailing Address - Fax:503-649-6854
Practice Address - Street 1:3595 SW 170TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5018
Practice Address - Country:US
Practice Address - Phone:503-649-7373
Practice Address - Fax:503-649-6854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1543261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT68056Medicare UPIN