Provider Demographics
NPI:1568009108
Name:SOMATIC INC
Entity Type:Organization
Organization Name:SOMATIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAIN SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILDMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-756-6424
Mailing Address - Street 1:3543 NE BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1820
Mailing Address - Country:US
Mailing Address - Phone:971-351-2270
Mailing Address - Fax:971-351-3035
Practice Address - Street 1:3543 NE BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1820
Practice Address - Country:US
Practice Address - Phone:971-351-2270
Practice Address - Fax:971-351-3035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty