NPIMap

Organization Active NPI

Portland Optimal Wellness, LLC

  • Chiropractor
  • Lake Oswego, OR
National Provider Identifier
1053836247
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4036 Issued in OR
Legal business name
PORTLAND OPTIMAL WELLNESS, LLC
Practice address
14511 Westlake Dr Ste 148
Lake Oswego, OR 97035-7773
Phone
(503) 941-5351
NPI assigned
Aug 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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

Authorized official

Name
Dr. Aaron Davison, DC
Title
Owner
Phone
(503) 686-4448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 4036 OR Primary

Addresses

Primary practice location

14511 Westlake Dr Ste 148
Lake Oswego, OR 97035-7773

Mailing address

14511 Westlake Dr Ste 148
Lake Oswego, OR 97035-7773

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502150400000",
    "number": "1053836247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14511 WESTLAKE DR STE 148",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14511 WESTLAKE DR STE 148",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357773",
            "telephone_number": "503-941-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND OPTIMAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-08-08",
        "status": "A",
        "authorized_official_last_name": "DAVISON",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-686-4448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "4036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.