Provider Demographics
NPI:1841403474
Name:CHIROPRACTIC AUTO INJURY CLINIC
Entity type:Organization
Organization Name:CHIROPRACTIC AUTO INJURY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZCHON
Authorized Official - Middle Name:R
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-284-7838
Mailing Address - Street 1:333 NE RUSSELL ST
Mailing Address - Street 2:SUITE #200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3762
Mailing Address - Country:US
Mailing Address - Phone:503-284-7838
Mailing Address - Fax:503-287-9659
Practice Address - Street 1:333 NE RUSSELL ST
Practice Address - Street 2:SUITE #200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3762
Practice Address - Country:US
Practice Address - Phone:503-284-7838
Practice Address - Fax:503-287-9659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty