Active NPI
Adam Goulet, D.C.
- Sports Physician Chiropractor
- Portland, OR
National Provider Identifier
1043571136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 5046
- Practice address
- 1501 N Aisworth
Portland, OR 97217 - Phone
- (425) 359-0999
- NPI assigned
- Jun 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 5046 | OR | Primary |
Addresses
Primary practice location
1501 N Aisworth
Portland, OR 97217
Mailing address
11301 NE 7TH St
#N2
Vancouver, WA 98684-5113
Phone (425) 359-0999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5046 | OR | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1043571136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11301 NE 7TH ST",
"address_2": "#N2",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986845113",
"telephone_number": "425-359-0999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 N AISWORTH",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97217",
"telephone_number": "425-359-0999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOULET",
"first_name": "ADAM",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-05",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "OR",
"license": "5046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.