Evergreen Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EVERGREEN CHIROPRACTIC PC

Practice address

657 NE Hood Ave
Gresham, OR 97030-7328

Phone

(503) 912-1156

Fax

(971) 292-2932

NPI assigned

Sep 24, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Jared Manns, DCNPI 1912554692

Title

Chiropractor/Owner

Phone

(503) 912-1156

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Jared Manns, DC

  • Chiropractor
  • Gresham, OR
  • NPI 1912554692
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1003423914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 BURMA RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353240",
            "telephone_number": "971-330-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 NE HOOD AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307328",
            "telephone_number": "503-912-1156",
            "fax_number": "971-292-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "MANNS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JARED",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "503-912-1156",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evergreen Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bradley H Evans, MD
• Jane Mary Evans, RN
• Stephanie Joann Evans, MD
• Valarie Malone Evart, LMSW
• Evercare Support LLC
• Evergreen Prosthetics and Orthotics, LLC
• Lexi Brynne Eveson
• Mary J Evrard, LPC
• Exodus LLC
• Eye Care Services, Inc.

• Chiropractor in Gresham, OR
• Providers in Gresham, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.