Provider Demographics
NPI:1891154415
Name:NW CHIROPRACTIC & MEDICAL REHAB
Entity Type:Organization
Organization Name:NW CHIROPRACTIC & MEDICAL REHAB
Other - Org Name:HINOJOSA CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:H
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-512-7076
Mailing Address - Street 1:205 NE 181ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-6615
Mailing Address - Country:US
Mailing Address - Phone:503-512-7076
Mailing Address - Fax:503-512-7092
Practice Address - Street 1:205 NE 181ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-6615
Practice Address - Country:US
Practice Address - Phone:503-512-7076
Practice Address - Fax:503-512-7092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty