Provider Demographics
NPI:1588834352
Name:RATHBONE CHIROPRACTIC CENTER, PC
Entity Type:Organization
Organization Name:RATHBONE CHIROPRACTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:RATHBONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-642-1449
Mailing Address - Street 1:3895 SW 185TH AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97007-8064
Mailing Address - Country:US
Mailing Address - Phone:503-642-1449
Mailing Address - Fax:503-642-1577
Practice Address - Street 1:3895 SW 185TH AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97007-8064
Practice Address - Country:US
Practice Address - Phone:503-642-1449
Practice Address - Fax:503-642-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR132857OtherMEDICARE GROUP PIN
ORT68035Medicare UPIN