Lee P Cowan, D.C.
Individual provider Active NPI Orthopedic Chiropractor · Gresham, OR
NPI 1114009156 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1114009156
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopedic Chiropractor 111NX0800X
- License
- 271566 (OR)
- Practice address
- 4322 SE 182ND Ave
Gresham, OR 97233 - Phone
- (503) 667-8988
- Fax
- (503) 667-8976
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 1979
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4322 SE 182ND Ave
Gresham, OR 97030-5058
Phone (503) 667-8988
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070716000736 | OR | Practitioner - Chiropractic | 7113027897 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1566 | OR | MD | Clinical Psychologist |
| 271566 | OR | MD | Orthopedic Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockwood Chiropractic Clinic, Inc | Orthopedic | Current |
Accepting new patients |
Locations
4322 SE 182nd Ave
Gresham, OR 97030
Phone (503) 667-8988
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | 271566 | OR | Yes |
Addresses
Primary practice location
4322 SE 182ND Ave
Gresham, OR 97233
Mailing address
4322 SE 182ND Ave
Gresham, OR 97030
Phone (503) 667-8988
Other providers in Gresham, OR
- Gabrielle Christine Cortes
- Jaymi Costanzo
- Charles Coughlin
- Courtney Family Enterprises Incorperated
- Brittany Courtney
- Vernon L Cowell
- Jennifer Rose Cox
- Richard Wayne Craft Sr.
- Craig S Montgomery PHD PC
- Bradley Dru Craig
All providers in Gresham, OR · Orthopedic Chiropractor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.