Provider Demographics
NPI:1740947878
Name:AD CHIROPRACTIC LLC
Entity type:Organization
Organization Name:AD CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEARBORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-626-3700
Mailing Address - Street 1:5035 NE ELAM YOUNG PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6489
Mailing Address - Country:US
Mailing Address - Phone:503-626-3700
Mailing Address - Fax:503-643-6667
Practice Address - Street 1:5035 NE ELAM YOUNG PKWY STE 300
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6489
Practice Address - Country:US
Practice Address - Phone:503-626-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1962949461OtherDC
OR1518117746OtherDC