Provider Demographics
NPI:1245474956
Name:ASULA CHIROPRACTIC AND WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:ASULA CHIROPRACTIC AND WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAILA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NOLL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-719-5335
Mailing Address - Street 1:818 NW MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3295
Mailing Address - Country:US
Mailing Address - Phone:503-719-5335
Mailing Address - Fax:
Practice Address - Street 1:818 NW MARSHALL
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209
Practice Address - Country:US
Practice Address - Phone:503-719-5335
Practice Address - Fax:503-719-5334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-24
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty