Organization Active NPI

Sylvan Chiropractic Clinic, LLC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1104094432
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 3668 Issued in OR
Legal business name
SYLVAN CHIROPRACTIC CLINIC, LLC
Practice address
5440 SW Westgate Dr
Suite 100
Portland, OR 97221-2420
Phone
(503) 297-4447
Fax
(503) 296-8414
NPI assigned
Feb 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Authorized official

Name
Dr. Seth Callaghan Alley, DCNPI 1487786026
Title
Clinic Director/Owner
Phone
(503) 297-4447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 27 3668 OR Primary

Addresses

Primary practice location

5440 SW Westgate Dr
Suite 100
Portland, OR 97221-2420

Mailing address

5440 SW Westgate Dr
Suite 100
Portland, OR 97221-2420
Phone (503) 297-4447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171227001550 OR Part B Supplier - Clinic/Group Practice 9234497074 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

5440 SW Westgate Dr
Ste 100
Portland, OR 97221
Phone (503) 297-4447

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1104094432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DR",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212420",
            "telephone_number": "503-297-4447",
            "fax_number": "503-296-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DR",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212420",
            "telephone_number": "503-297-4447",
            "fax_number": "503-296-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYLVAN CHIROPRACTIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "ALLEY",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "CALLAGHAN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR/OWNER",
        "authorized_official_telephone_number": "503-297-4447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 3668",
            "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 Jan 28, 2013; 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.