NPIMap

Organization Active NPI

Healthletics Chiropractic Clinic LLC

  • Clinic/Center
  • Corvallis, OR
National Provider Identifier
1437208303
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
3661 Issued in OR
Legal business name
HEALTHLETICS CHIROPRACTIC CLINIC LLC
Practice address
2005 NW Grant Ave
Corvallis, OR 97330-4366
Phone
(503) 449-4945
Fax
(541) 738-0704
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Dr. Keith James Okerstrom, DC
Title
Chiropractor and Manager
Phone
(541) 758-9393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 3661 OR Primary

Addresses

Primary practice location

2005 NW Grant Ave
Corvallis, OR 97330-4366

Mailing address

2005 NW Grant Ave
Corvallis, OR 97330-4366
Phone (503) 449-4945

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1437208303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 NW GRANT AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304366",
            "telephone_number": "503-449-4945",
            "fax_number": "541-738-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 NW GRANT AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304366",
            "telephone_number": "503-449-4945",
            "fax_number": "541-738-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHLETICS CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "OKERSTROM",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIROPRACTOR AND MANAGER",
        "authorized_official_telephone_number": "541-758-9393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "3661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.