Provider Demographics
NPI:1437705407
Name:S2 COLLABORATIONS LLC
Entity Type:Organization
Organization Name:S2 COLLABORATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-270-1030
Mailing Address - Street 1:3300 SW HOCKEN AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2444
Mailing Address - Country:US
Mailing Address - Phone:360-270-1030
Mailing Address - Fax:503-325-9135
Practice Address - Street 1:3300 SW HOCKEN AVE STE 108
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2444
Practice Address - Country:US
Practice Address - Phone:360-270-1030
Practice Address - Fax:503-325-9135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S2 COLLABORATIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty