NPIMap

Organization Active NPI

Milwaukie Chiropractic - Dr. Jesse Brockey LLC

Doing business as Columbia Pacific Chiropractic

  • Chiropractor
  • Warrenton, OR
National Provider Identifier
1154779791
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5008 Issued in OR
Legal business name
MILWAUKIE CHIROPRACTIC - DR. JESSE BROCKEY LLC
Doing business as
Columbia Pacific Chiropractic
Practice address
679 E Harbor Dr
#140
Warrenton, OR 97146-9717
Phone
(503) 861-1661
Fax
(503) 861-0254
NPI assigned
May 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Jesse Owen Brockey, D.C.NPI 1942583711
Title
Owner/Chiropractor
Phone
(503) 861-1661

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5008 OR Primary

Addresses

Primary practice location

679 E Harbor Dr
#140
Warrenton, OR 97146-9717

Mailing address

PO Box 576
Warrenton, OR 97146-0576
Phone (503) 861-1661

Other identifiers 1

IdentifierTypeStateIssuer
R172616OtherORMEDICARE PTAN

Other names 1

  • Columbia Pacific Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

679 E Harbor Dr
Ste 140
Warrenton, OR 97146
Phone (503) 338-8383

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1154779791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576",
            "city": "WARRENTON",
            "state": "OR",
            "postal_code": "971460576",
            "telephone_number": "503-861-1661",
            "fax_number": "503-861-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 E HARBOR DR",
            "address_2": "#140",
            "city": "WARRENTON",
            "state": "OR",
            "postal_code": "971469717",
            "telephone_number": "503-861-1661",
            "fax_number": "503-861-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKIE CHIROPRACTIC - DR. JESSE BROCKEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "BROCKEY",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "OWEN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "503-861-1661",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R172616",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Pacific Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warrenton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.