Provider Demographics
NPI:1376701375
Name:EUROPEAN CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:EUROPEAN CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:IVO
Authorized Official - Last Name:POUL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-557-2225
Mailing Address - Street 1:1205 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1644
Mailing Address - Country:US
Mailing Address - Phone:503-557-2225
Mailing Address - Fax:503-557-2080
Practice Address - Street 1:1205 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1644
Practice Address - Country:US
Practice Address - Phone:503-557-2225
Practice Address - Fax:503-557-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1959111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR10858-9Medicaid
OR10858-9Medicaid