Active NPI
Elite Medical Center Chiropractic & Massage
- Chiropractor
- Portland, OR
National Provider Identifier
1407320435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Legal business name
- ELITE MEDICAL CENTER CHIROPRACTIC & MASSAGE
- Practice address
- 1350 SE 122ND Ave
Portland, OR 97233-1203 - Phone
- (503) 889-0906
- Fax
- (503) 894-9557
- NPI assigned
- Jan 12, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alexi Gudishvili
- Title
- General Manager
- Phone
- (503) 509-4840
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | Primary |
Addresses
Primary practice location
1350 SE 122ND Ave
Portland, OR 97233-1203
Mailing address
1350 SE 122ND Ave
Portland, OR 97233-1203
Phone (503) 889-0906
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547251200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693440000000",
"number": "1407320435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 SE 122ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331203",
"telephone_number": "503-889-0906",
"fax_number": "503-894-9557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 SE 122ND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331203",
"telephone_number": "503-889-0906",
"fax_number": "503-894-9557"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE MEDICAL CENTER CHIROPRACTIC & MASSAGE",
"organizational_subpart": "NO",
"enumeration_date": "2019-01-12",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A",
"authorized_official_last_name": "GUDISHVILI",
"authorized_official_first_name": "ALEXI",
"authorized_official_title_or_position": "GENERAL MANAGER",
"authorized_official_telephone_number": "503-509-4840"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
- Brandi Elise, LCSW
- Elite Body Therapy LLC
- Elite Chiropractic and Massage Center
- Elite Chiropractic Group
- Elite Endodontics
- Elite Orthopaedic Physical Therapy and Sports Performance
- Elite Upper Cervical LLC
- Eliza Rowley L.Ac. (Water's Way Acupuncture)
- Elizabeth a. Schmick DO LLC
- Elizabeth Busetto ND LLC (Rose Natural Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.