Active NPI
Jooae Park, D.C
- Chiropractor
- Canby, OR
National Provider Identifier
1245482314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3861
- Practice address
- 178 SW 2ND Ave
Canby, OR 97013-4152 - Phone
- (503) 266-2997
- NPI assigned
- Oct 21, 2008
- Last updated
- Oct 21, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3861 | OR | Primary |
Addresses
Primary practice location
178 SW 2ND Ave
Canby, OR 97013-4152
Mailing address
2073 SW Park Ave
Apt. #123
Portland, OR 97201-3122
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3861 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1245482314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2073 SW PARK AVE",
"address_2": "APT. #123",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972013122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "178 SW 2ND AVE",
"city": "CANBY",
"state": "OR",
"postal_code": "970134152",
"telephone_number": "503-266-2997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JOOAE",
"credential": "D.C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "3861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canby, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.