CHIROPRACTIC LIFE CENTER PC (NPI# 1235302795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235302795 |
| Entity Type | Organization |
| Organization Name | CHIROPRACTIC LIFE CENTER PC |
| Other Organization Name | CHIROPRACTIC LIFE CENTER |
| Practice Address |
12762 Se Stark St Plaza 125, Bldg D Portland OR 97233-1539 |
| Practice Telephone | 5032557746 |
| Practice Fax Number | 5032550818 |
| Mailing Telephone | 5032557746 |
| Mailing Fax Number | 5032550818 |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2019-08-01 |
| Authorized Official Name | MARK RONALD JOHANSEN (OWNER) |
| Authorized Official Telephone | 5032557746 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NX0800X |
Chiropractor Specialization: Orthopedic |
271737 | OR | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Chiropractic Life Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538112677 | Chiropractic Life Center PC | Chiropractor | 305 Nw Englewood Ct, Suite: 200, Gladstone, MO 64118-4072 | 2006-05-18 |
| Street Address |
12762 SE STARK ST PLAZA 125, BLDG D |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-1539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043301088 | James Lee Andrews | Chiropractor | 12762 Se Stark St, Plaza 125, Bldg D, Portland, OR 97233-1539 | 2006-09-27 |
| 1255680831 | Mark Ronald Johansen | Chiropractor | 12762 Se Stark St, Plaza 125 Bldg. D, Portland, OR 97233-1539 | 2012-08-29 |
| 1043302409 | Ronald R Johansen | Chiropractor | 12762 Se Stark St, Plaza 125 Bldg D, Portland, OR 97233-1539 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 111NX0800X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Orthopedic |
| Chiropractic Orthopedics is defined as that branch of chiropractic medicine that includes the continued acquisition of knowledge relative to both normal functions and diseases of the human body as they relate to the bones, joints, capsules, discs, muscles, ligaments, tendons, their complete neurological and vascular components, referred organ systems and contiguous tissues. This also includes the development and perfection of skills relative to health maintenance when such exists and when not, the investigations, historical review, physical detection, correlative diagnosis development and complete management of any disorder within the bounds defined herein. Also necessary is the delivery of the combined knowledge and skill on a primary basis to patients who both need and desire this service to the eventual outcome of remissions, whenever resolution is not readily achievable. In addition the certified chiropractic orthopedist provides consultation services at the request of other qualified doctors seeking assistance in the care of their patients. The chiropractic orthopedist may also engage in the teaching and or research of subjects and materials relevant to pursuing the quest for knowledge in the ever changing field of the orthopedic specialty. |
| Notes: Source: American Chiropractic Association, 2008 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790050086 | Hayes Chiropractic P.C. | Chiropractor | 808 Stevens Ave, Portland, ME 04103-2623 | 2012-03-20 |
| 1861654972 | Lenore Susan Difiore | Chiropractor | 129 Alice St, Portland, ME 04103-2257 | 2008-06-30 |
| 1174732812 | Milton Earl Duncan | Chiropractor | 6026 Ne Sandy Blvd, Portland, OR 97213-3963 | 2007-05-21 |
| 1710004932 | Betsy J Mitchell | Chiropractor | 3701 Se Milwaukie Ave, Portland, OR 97202-3835 | 2007-03-23 |
| 1710036744 | Dana William Sibilla | Chiropractor | 1934 Ne Broadway St, Portland, OR 97232-1502 | 2007-01-09 |
| 1578501755 | Michael J. Burke | Chiropractor | 2526 Ne 15th Ave, Portland, OR 97212-4222 | 2006-06-02 |
| 1942299557 | George Alan Ulbrich | Chiropractor | 6422 Se Milwaukie Ave, Portland, OR 97202-5518 | 2005-10-17 |
| 1497303994 | Emily Welch | Chiropractor | 406 W Votaw St, Portland, IN 47371-1344 | 2019-08-28 |
| 1073040945 | Taylor Justine Mohr | Chiropractor | 13112 Ne Halsey St, Portland, OR 97230-2350 | 2017-05-22 |
| 1801070891 | Community Chiropractic and Exercise Management | Chiropractor | 1516 Se 43rd Ave, Portland, OR 97215-3112 | 2007-12-26 |
| Find all providers in PORTLAND | ||||
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| 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.