Provider Demographics
NPI:1568608958
Name:VERIX MEDICAL LLC
Entity Type:Organization
Organization Name:VERIX MEDICAL LLC
Other - Org Name:VERIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARTWIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-737-9300
Mailing Address - Street 1:12425 NE GLISAN ST
Mailing Address - Street 2:STE B
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-2144
Mailing Address - Country:US
Mailing Address - Phone:503-737-9300
Mailing Address - Fax:
Practice Address - Street 1:12425 NE GLISAN ST
Practice Address - Street 2:STE B
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-2144
Practice Address - Country:US
Practice Address - Phone:503-737-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty