Provider Demographics
NPI:1760649198
Name:SOLUTIONS SPORTS AND SPINE, INC
Entity Type:Organization
Organization Name:SOLUTIONS SPORTS AND SPINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:W
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:971-266-0957
Mailing Address - Street 1:2600 NE MULTNOMAH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2130
Mailing Address - Country:US
Mailing Address - Phone:971-266-0957
Mailing Address - Fax:503-994-1917
Practice Address - Street 1:815 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1219
Practice Address - Country:US
Practice Address - Phone:971-266-0957
Practice Address - Fax:503-994-1917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 3379261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center