Provider Demographics
NPI:1649552449
Name:CARL E. SWARTS
Entity type:Organization
Organization Name:CARL E. SWARTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SWARTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-568-6524
Mailing Address - Street 1:17150 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-9290
Mailing Address - Country:US
Mailing Address - Phone:503-668-6524
Mailing Address - Fax:
Practice Address - Street 1:17150 UNIVERSITY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-9290
Practice Address - Country:US
Practice Address - Phone:503-668-6524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR0000QGHBBMedicare PIN
ORU50788Medicare UPIN