Provider Demographics
NPI:1649690660
Name:CONTEMPORARY CHIROPRACTIC PS
Entity type:Organization
Organization Name:CONTEMPORARY CHIROPRACTIC PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-901-8800
Mailing Address - Street 1:9895 SE SUNNYSIDE RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5740
Mailing Address - Country:US
Mailing Address - Phone:503-659-0121
Mailing Address - Fax:503-659-0119
Practice Address - Street 1:9895 SE SUNNYSIDE RD
Practice Address - Street 2:SUITE L
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5740
Practice Address - Country:US
Practice Address - Phone:503-659-0121
Practice Address - Fax:503-659-0119
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTEMPORARY CHIROPRACTIC PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1501261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty