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EASTSIDE WELLNESS CENTER LLC NPI 1053504696


NPI Information

NPI: 1053504696
Provider Name: EASTSIDE WELLNESS CENTER, LLC

Doing Business As: ELEMENT WELLNESS AND SPORTS REHABILITATION

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
5331 SW MACADAM AVE
SUITE 105
PORTLAND, OR
ZIP 97239
Phone: (503) 445-7999
Get Directions

EASTSIDE WELLNESS CENTER, LLC 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. EASTSIDE WELLNESS CENTER, LLC NPI is 1053504696. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Element Wellness And Sports Rehabilitation.

The provider's business location address is:

5331 SW MACADAM AVE
SUITE 105
PORTLAND, OR
ZIP 97239-104
Phone: (503) 445-7999
Fax: (503) 445-7997

The provider's authorized official is Noah I Goodwill .
The authorized official title is Owner and has the following contact phone number (503) 445-7999.

The enumeration date for this NPI number is 8/27/2007 and was last updated on 12/13/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1225100000XPhysical Therapist3758OREGONNo
2111N00000XChiropractor3372OREGONYes

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: 11/14/2023

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