Provider Demographics
NPI:1720634108
Name:ACCIDENT CARE CHIROPRACTIC AND MASSAGE OF CLACKAMAS INC
Entity Type:Organization
Organization Name:ACCIDENT CARE CHIROPRACTIC AND MASSAGE OF CLACKAMAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER, CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDEI
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS
Authorized Official - Phone:503-850-4762
Mailing Address - Street 1:10201 SE SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9782
Mailing Address - Country:US
Mailing Address - Phone:503-850-4762
Mailing Address - Fax:503-850-6182
Practice Address - Street 1:10201 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9782
Practice Address - Country:US
Practice Address - Phone:503-850-4762
Practice Address - Fax:503-850-6182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1811439136Medicaid
OR1821524976Medicaid