Provider Demographics
NPI:1811396468
Name:WEST CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:WEST CHIROPRACTIC LLC
Other - Org Name:WEST CHIROPACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIRPORACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KURTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:971-777-0237
Mailing Address - Street 1:30485 SW BOONES FERRY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-7845
Mailing Address - Country:US
Mailing Address - Phone:971-777-0237
Mailing Address - Fax:
Practice Address - Street 1:30485 SW BOONES FERRY RD STE 104
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-7845
Practice Address - Country:US
Practice Address - Phone:971-777-0237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5550111N00000X
OR5573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty