Back in Motion Sports Injuries Clinic, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BACK IN MOTION SPORTS INJURIES CLINIC, LLC

Practice address

11385 SW Scholls Ferry Rd
Beaverton, OR 97008-7167

Phone

(503) 524-9040

Fax

(503) 579-4727

NPI assigned

May 4, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theodore Lawrence Forcum III, DC, DACBSP, CSCSNPI 1346298957

Title

Owner

Phone

(503) 524-9040

Specialties & licenses 4

Addresses

Practitioners 1

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.

• Theodore L Forcum III, DC

  • Sports Physician Chiropractor
  • Astoria, OR
  • NPI 1346298957
  NPD (past) Authorized official

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1194937722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11385 SW SCHOLLS FERRY RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087167",
            "telephone_number": "503-524-9040",
            "fax_number": "503-579-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11385 SW SCHOLLS FERRY RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087167",
            "telephone_number": "503-524-9040",
            "fax_number": "503-579-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN MOTION SPORTS INJURIES CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FORCUM",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-524-9040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DC, DACBSP, CSCS"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahvash Azadegan, LMFT
• Ezra Azhar, MD
• Christine A Babinec, MA, LPC, NCC
• Tyler Baca
• Vanessa Baccellieri
• Serita Backstrand, PSY.D
• Amelia Backus
• Robyn Aleen Baehler, LMT
• Jessica Anne Baele, PA-C
• Juliet Baele X, MD

• Specialist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.