Organization Active NPI

C and C Chiropractic

  • Chiropractor
  • Beaverton, OR
National Provider Identifier
1154600567
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3215 Issued in OR
Legal business name
C AND C CHIROPRACTIC
Practice address
17200 NW Corridor CT
Suite 100
Beaverton, OR 97006-3295
Phone
(503) 617-0906
Fax
(503) 617-0949
NPI assigned
Aug 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Authorized official

Name
Maria Estela Mandujano
Title
Office Manager
Phone
(503) 617-0906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3215 OR Primary

Addresses

Primary practice location

17200 NW Corridor CT
Suite 100
Beaverton, OR 97006-3295

Mailing address

17200 NW Corridor CT
Suite 100
Beaverton, OR 97006-3295
Phone (503) 617-0906

Other identifiers 1

IdentifierTypeStateIssuer
1043381593OtherORINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

17200 NW Corridor Ct
Ste 100
Beaverton, OR 97006
Phone (503) 213-3800

Practitioners & affiliated clinicians

Practitioners 3

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": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1154600567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT",
            "address_2": "SUITE 100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-617-0906",
            "fax_number": "503-617-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 NW CORRIDOR CT",
            "address_2": "SUITE 100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970063295",
            "telephone_number": "503-617-0906",
            "fax_number": "503-617-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C AND C CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "MANDUJANO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ESTELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-617-0906"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1043381593",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.