Provider Demographics
NPI:1871750976
Name:OREGON CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:OREGON CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-699-9299
Mailing Address - Street 1:15962 BOONES FERRY RD
Mailing Address - Street 2:101
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-4351
Mailing Address - Country:US
Mailing Address - Phone:503-699-9299
Mailing Address - Fax:503-699-0718
Practice Address - Street 1:15962 BOONES FERRY RD
Practice Address - Street 2:101
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-4351
Practice Address - Country:US
Practice Address - Phone:503-699-9299
Practice Address - Fax:503-699-0718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1271111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000QGBHKMedicare UPIN