DR. SHANE ALAN GOFOURTH (NPI# 1861427627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861427627 |
| Entity Type | Individual |
| Full Name | DR. SHANE ALAN GOFOURTH |
| Credential | D.C. |
| Practice Address |
88124 Territorial Rd. Veneta OR 97487 |
| Mailing Address |
Po Box 1108 Veneta OR 97487-1108 |
| Practice Telephone | 5419352242 |
| Practice Fax Number | 5419352242 |
| Mailing Telephone | 5419352242 |
| Mailing Fax Number | 5419352242 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-06-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 27 3292 | OR | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OMAP | 228849 | 01 |
| Street Address |
88124 TERRITORIAL RD. |
| City | VENETA |
| State | OR |
| Zip Code | 97487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962858464 | All Seasons Family Medicine PC | Preferred Provider Organization | 25045 Dunham Ave., Veneta, OR 97487 | 2016-05-13 |
| 1932440492 | Elizabeth Jane Hoffmann | Veterinarian | 88233 Territorial Hwy, Veneta, OR 97487 | 2013-03-08 |
| 1730429986 | Ryan P Frome | Veterinarian | 88233 Territorial Rd, Veneta, OR 97487 | 2013-02-26 |
| 1225254402 | Tracy R Robinson | Dentist | 25078 Hunter Rd., Veneta, OR 97487 | 2007-04-17 |
| 1770650707 | Christa Hitt | Counselor | 87576 Trek Drive, Veneta, OR 97487 | 2006-11-28 |
| 1871665745 | Donald C. Stair | Dentist | 25078 Hunter Ave, Veneta, OR 97487 | 2006-11-15 |
| 1518990621 | Icco, LLC | Family Medicine | 87983 Territorial Rd, Veneta, OR 97487 | 2006-07-09 |
| 1043272214 | Select Physical Therapy Orthopedic Services Inc | Clinic/Center | 24947 Highway 126, Suite D, Veneta, OR 97487 | 2006-04-04 |
| 1437713252 | Veneta Family Dental | Dentist | 25078 Hunter Rd, Veneta, OR 97487 | 2019-04-26 |
| 1083159503 | Icco, LLC | Clinic/Center | 25045 Dunham Avenue, Veneta, OR 97487 | 2016-12-20 |
| Find all providers in zip 97487 | ||||
| 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 |
|---|---|---|---|---|
| 1922005339 | Renata A Hennell | Chiropractor | 88267 N Territorial Rd, Suite 5, Veneta, OR 97487-9499 | 2005-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093999 | Allison Robinson | Chiropractor | 1225 Multnomah Rd, Hood River, OR 97031-9713 | 2020-11-04 |
| 1073113635 | Adam Hernandez | Chiropractor | 10208 Sw Conestoga Dr Apt 41, Beaverton, OR 97008-8416 | 2020-10-31 |
| 1700486958 | Amy Elizabeth Goebel | Chiropractor | 5103 Se Stark St Apt B, Portland, OR 97215-1764 | 2020-10-27 |
| 1053918193 | Evan Chin | Chiropractor | 3615 Sw Hall Blvd, Beaverton, OR 97005-2053 | 2020-10-01 |
| 1003423914 | Evergreen Chiropractic PC | Chiropractor | 7145 Sw Varns St Ste 203, Portland, OR 97223-8168 | 2020-09-24 |
| 1013522358 | Terri Ann Truesdale | Chiropractor | 4455 Sw Salmon Pl, Redmond, OR 97756-1983 | 2020-09-14 |
| 1750993283 | University of Western States Healthcare Inc | Chiropractor | 8000 Ne Tillamook St, Portland, OR 97213-6655 | 2020-08-17 |
| 1902421811 | John Paul Hurd | Chiropractor | 21885 Or62, Shady Cove, OR 97539 | 2020-06-16 |
| 1396360210 | Urban Health Chiropractic LLC | Chiropractor | 1610 N Adair St Ste D, Cornelius, OR 97113-8832 | 2020-06-16 |
| 1518587989 | Kristy Pearl Arneson | Chiropractor | 3715 Se Cesar E Chavez Blvd, Portland, OR 97202-1704 | 2020-04-25 |
| Find all providers with the same taxonomy | ||||
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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.