Provider Demographics
NPI:1356828750
Name:ACCIDENT CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:ACCIDENT CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLUEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:503-282-4878
Mailing Address - Street 1:3220 N WILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1551
Mailing Address - Country:US
Mailing Address - Phone:503-282-4878
Mailing Address - Fax:
Practice Address - Street 1:1111 W SPRUCE ST STE 28
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3263
Practice Address - Country:US
Practice Address - Phone:509-452-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty