ELEMENT WELLNESS AND SPORTS REHABILITATION – NPI #1053504696
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.

Health Care Provider Taxonomy Code for Chiropractor

ELEMENT WELLNESS AND SPORTS REHABILITATION is a chiropractor located in PORTLAND, OR. NPPES has assigned the NPI number 1053504696 to ELEMENT WELLNESS AND SPORTS REHABILITATION on August 27, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ELEMENT WELLNESS AND SPORTS REHABILITATION” is a dba name, the actual legal business name for this organization is EASTSIDE WELLNESS CENTER, LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 111N00000X from the Health Care Provider Taxonomy code set, which is classified as Chiropractor.

The NPI profile was previously updated about 13 years ago on Dec 13, 2012. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ELEMENT WELLNESS AND SPORTS REHABILITATION below.

NPI Profile for
EASTSIDE WELLNESS CENTER, LLC

NPI Number
1053504696
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EASTSIDE WELLNESS CENTER, LLC
Doing Business As (dba): ELEMENT WELLNESS AND SPORTS REHABILITATION
Primary location
5331 SW MACADAM AVE
SUITE 105
PORTLAND, OR 97239-6104
Phone: (503) 445-7999 Fax: (503) 445-7997
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
NOAH GOODWILL
OWNER
Phone: (503) 445-7999
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
111N00000X
- Chiropractor (Primary)		 OR 3372
225100000X
- Physical Therapist		 OR 3758

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.