Provider Demographics
NPI:1477092351
Name:NEIGHBORHOOD CHIROPRACTIC AND ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:NEIGHBORHOOD CHIROPRACTIC AND ACUPUNCTURE LLC
Other - Org Name:NEIGHBORHOOD CHIROPRACTIC AND ACUPUNCTURE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLIE
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:DASHIELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-236-8701
Mailing Address - Street 1:6040 SE BELMONT ST
Mailing Address - Street 2:SUITE 1230
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-1974
Mailing Address - Country:US
Mailing Address - Phone:503-236-8701
Mailing Address - Fax:503-236-8710
Practice Address - Street 1:6040 SE BELMONT ST
Practice Address - Street 2:SUITE 1230
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1974
Practice Address - Country:US
Practice Address - Phone:503-236-8701
Practice Address - Fax:503-236-8710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR176352Medicare PIN