Provider Demographics
NPI:1245779958
Name:POHLE, AMY (DC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:POHLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15220 NW GREENBRIER PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8111
Mailing Address - Country:US
Mailing Address - Phone:503-439-9494
Mailing Address - Fax:503-645-4404
Practice Address - Street 1:15220 NW GREENBRIER PKWY STE 260
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006
Practice Address - Country:US
Practice Address - Phone:562-961-7660
Practice Address - Fax:503-439-9494
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33793111N00000X
KY5581111N00000X
OR5837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor