NPIMap

Organization Active NPI

Willamette Valley Wellness LLC

  • Chiropractor
  • Salem, OR
National Provider Identifier
1194069450
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3989 Issued in OR
Legal business name
WILLAMETTE VALLEY WELLNESS LLC
Practice address
4356 Commercial Street SE
Salem, OR 97302
Phone
(503) 689-1216
Fax
(503) 689-1520
NPI assigned
Nov 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Dr. Joshua R Wolfram, DC
Title
Owner
Phone
(503) 689-1216

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3989 OR Primary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X 13553 OR
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X 17108 OR
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X 14327 OR

Addresses

Primary practice location

4356 Commercial Street SE
Salem, OR 97302

Mailing address

4356 Commercial Street SE
Salem, OR 97302
Phone (503) 689-1216

National Provider Directory

National Provider Directory

Locations

4356 Commercial St SE
Salem, OR 97302
Phone (503) 383-9375

Practitioners & affiliated clinicians

Practitioners 6

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": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1194069450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4356 COMMERCIAL STREET SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-689-1216",
            "fax_number": "503-689-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4356 COMMERCIAL STREET SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-689-1216",
            "fax_number": "503-689-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE VALLEY WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "WOLFRAM",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-689-1216",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3989",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "13553",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17108",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "14327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.