ACTIVE WELLNESS CHIROPRACTIC,PC (NPI# 1033518600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033518600 |
| Entity Type | Organization |
| Organization Name | ACTIVE WELLNESS CHIROPRACTIC,PC |
| Practice Address |
1815 Sw Marlow Ave Suite 206 Portland OR 97225-5185 |
| Practice Telephone | 5037891014 |
| Practice Fax Number | 8779859111 |
| Mailing Telephone | 5037891014 |
| Mailing Fax Number | 8779859111 |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |
| Authorized Official Name | DR. MEGAN DEJANA (CEO) |
| Authorized Official Telephone | 5037891014 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3632 | OR | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | NPI TYPE 1 | 1871506600 | 01 |
| Street Address |
1815 SW MARLOW AVE SUITE 206 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790760908 | Progressive Rehabilitation Associates LLC | Clinic/Center | 1815 Sw Marlow Ave, Suite 110, Portland, OR 97225-5185 | 2005-12-09 |
| 1831612845 | Amy Crowell | Occupational Therapy Assistant | 1815 Sw Marlow Ave, 110, Portland, OR 97225 | 2017-07-21 |
| 1487188199 | Project Quest | Counselor | 1815 Sw Marlow Ave, 110, Portland, OR 97225-5185 | 2017-04-19 |
| 1700310075 | Steven Washburn | Counselor | 1815 Sw Marlow Ave, 110, Portland, OR 97225-5185 | 2017-04-13 |
| 1851752471 | Progressive Rehabilitation Associates, LLC | Clinic/Center | 1815 Sw Marlow Ave, Ste 110, Portland, OR 97225-5185 | 2016-03-09 |
| 1295106482 | Jodi Elizabeth Johnson Palensky | Psychologist | 1815 Sw Marlow Ave, Suite 110, Portland, OR 97225-5185 | 2015-10-13 |
| 1083037238 | Caren Gail Cohen | Occupational Therapist | 1815 Sw Marlow Ave, Ste. 110, Portland, OR 97225-5185 | 2014-01-23 |
| 1326486234 | Daniel Howard Cooper | Physical Therapist | 1815 Sw Marlow Ave, Ste 110, Portland, OR 97225-5185 | 2013-06-13 |
| 1386990646 | Lorna J Defreest | Occupational Therapy Assistant | 1815 Sw Marlow Ave, Ste 110, Portland, OR 97225-5185 | 2012-07-24 |
| 1063794261 | Margo Cohn Pactanac | Counselor | 1815 Sw Marlow Ave, Suite 218, Portland, OR 97225-5185 | 2011-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486958 | Amy Elizabeth Goebel | Chiropractor | 5103 Se Stark St Apt B, Portland, OR 97215-1764 | 2020-10-27 |
| 1003423914 | Evergreen Chiropractic PC | Chiropractor | 7145 Sw Varns St Ste 203, Portland, OR 97223-8168 | 2020-09-24 |
| 1750993283 | University of Western States Healthcare Inc | Chiropractor | 8000 Ne Tillamook St, Portland, OR 97213-6655 | 2020-08-17 |
| 1518587989 | Kristy Pearl Arneson | Chiropractor | 3715 Se Cesar E Chavez Blvd, Portland, OR 97202-1704 | 2020-04-25 |
| 1770102956 | Behireta Corbadzic | Chiropractor | 12923 Se Foster Rd Unit G703, Portland, OR 97236-4702 | 2020-04-08 |
| 1134754427 | Bonnie Anderson | Chiropractor | 3539 N Williams Ave Ste 202a, Portland, OR 97227-1437 | 2020-03-06 |
| 1629601372 | Megan Adele Robles | Chiropractor | 2100 Ne Broadway St Ste 255, Portland, OR 97232-1544 | 2020-02-20 |
| 1306479472 | Naomi M Enos-burles | Chiropractor | 7332 Sw 13th Dr Apt A, Portland, OR 97219-2089 | 2020-02-18 |
| 1184256927 | Michael Nicosia | Chiropractor | 207 Santa Monica St, Portland, TX 78374-2645 | 2020-02-10 |
| 1942832258 | Tracy Yvonne Still | Chiropractor | 3905b Ne Grand Ave Unit B, Portland, OR 97212-1107 | 2020-02-05 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on ACTIVE WELLNESS CHIROPRACTIC,PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.