Provider Demographics
NPI:1346410800
Name:ALLEN KNECHT, DC, PC
Entity Type:Organization
Organization Name:ALLEN KNECHT, DC, PC
Other - Org Name:NAMASTE INTEGRATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:KNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-226-8010
Mailing Address - Street 1:5331 SW MACADAM AVENUE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3859
Mailing Address - Country:US
Mailing Address - Phone:503-226-8010
Mailing Address - Fax:503-210-0338
Practice Address - Street 1:5331 SW MACADAM AVENUE
Practice Address - Street 2:SUITE 307
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3859
Practice Address - Country:US
Practice Address - Phone:503-226-8010
Practice Address - Fax:503-210-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR080254Medicaid
OR000800000OtherBLUE CROSS/ BLUE SHEILD
60016070OtherTAT NUMBER
OR080254Medicaid
ORU65164Medicare UPIN