DR. JORDAN GUY PROBASCO D.C. NPI 1174901490

NPI Information

NPI: 1174901490
Provider Name: DR. JORDAN GUY PROBASCO, D.C.
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
12661 SE POWELL BLVD
SUITE B
PORTLAND, OR
ZIP 97236
Phone: (503) 801-8888
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DR. Jordan Guy Probasco, D.C. is a chiropractor in Portland, OR. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DR. Jordan Guy Probasco, D.C. NPI is 1174901490. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12661 SE POWELL BLVD
SUITE B
PORTLAND, OR
ZIP 97236-400
Phone: (503) 801-8888

The enumeration date for this NPI number is 5/7/2015 and was last updated on 5/7/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111NP0017X	Chiropractor	Pediatric Chiropractor	5631	OREGON	No
2	111NR0400X	Chiropractor	Rehabilitation	5631	OREGON	No
3	111NX0100X	Chiropractor	Occupational Health	5631	OREGON	No
4	111NX0800X	Chiropractor	Orthopedic	5631	OREGON	No
5	111N00000X	Chiropractor		5631	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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