Active Oregon Chiropractic
Organization Active NPI Chiropractor · Gladstone, OR
NPI 1265877856 · NPPES record last updated Apr 18, 2023
Key facts
- NPI
- 1265877856
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5140 (OR)
- Legal business name
- ACTIVE OREGON CHIROPRACTIC
- Practice address
- 130 W Clarendon St
Gladstone, OR 97027-2335 - Phone
- (503) 655-2897
- Fax
- (503) 655-2894
- NPI assigned
- May 8, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Stephanie L Tolonen, DC, MS
- Title
- Owner/Chiropractic Physician
- Phone
- (503) 655-2897
Practitioners 12
-
Brandy Careri, DC
-
Stephanie Lynn Tolonen, DC MS CCSP
-
John Sanford, LMT
-
Bradley D Clunes, DC
-
Daniel Kemper, DC
-
Maurice William Smith, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171228001094 | OR | Part B Supplier - Clinic/Group Practice | 5799043592 |
Receives reassigned benefits from 3 practitioners Practice locations: Gladstone, OR |
National Provider Directory
Locations
130 W Clarendon St
Gladstone, OR 97027
Phone (503) 655-2897
357 Warner Milne Rd
Oregon City, OR 97045
Phone (503) 227-2279
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 5140 | OR | Yes |
| Health Service Clinic/Center | 261QH0100X |
Addresses
Primary practice location
130 W Clarendon St
Gladstone, OR 97027-2335
Mailing address
130 W Clarendon St
Gladstone, OR 97027-2335
Phone (503) 655-2897
Other providers in Gladstone, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.