Provider Demographics
NPI:1578947412
Name:J2.0, LLC
Entity Type:Organization
Organization Name:J2.0, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:971-348-3710
Mailing Address - Street 1:8835 SW CANYON LN STE 120
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-3451
Mailing Address - Country:US
Mailing Address - Phone:971-348-3710
Mailing Address - Fax:971-348-3711
Practice Address - Street 1:8835 SW CANYON LN STE 120
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-3451
Practice Address - Country:US
Practice Address - Phone:971-348-3710
Practice Address - Fax:971-348-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR182605Medicare PIN