Kruse Park Chiropractic Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1674 Issued in OR

Legal business name

KRUSE PARK CHIROPRACTIC CLINIC LLC

Practice address

3990 Collins Way
201
Lake Oswego, OR 97035-3459

Phone

(503) 635-1236

Fax

(503) 697-4741

NPI assigned

Nov 2, 2011

Organization subpart

No

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

Authorized official

Name

Kathleen M Galligan, D.C.

Title

Owner

Phone

(503) 635-1236

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341792000000",
    "number": "1417233560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 COLLINS WAY",
            "address_2": "201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353459",
            "telephone_number": "503-635-1236",
            "fax_number": "503-697-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 COLLINS WAY",
            "address_2": "201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353459",
            "telephone_number": "503-635-1236",
            "fax_number": "503-697-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRUSE PARK CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2012-07-09",
        "status": "A",
        "authorized_official_last_name": "GALLIGAN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-635-1236",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "1674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R109099",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Sherwood Kosta, P.T.
• KP Chiropractic Services PC
• Amy Krause
• Jenna Krevosky, M.ED
• Kristina E Harp M.D P.C
• Kruse Park Chiropractic LLC
• Christopher William Kryger, LCSW
• Wendy Luo Kryski
• Sayali D Kulkarni, FNP
• Feben Kurban, AU.D.

• Chiropractor in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.