The Good Place NW, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

THE GOOD PLACE NW, INC

Practice address

960 Broadway St NE Ste 1
Salem, OR 97301-1275

Phone

(503) 967-6638

Fax

(503) 339-7038

NPI assigned

Nov 30, 2018

Organization subpart

No

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

Authorized official

Name

Clint Wissinger

Title

Owner

Phone

(503) 877-8902

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1538639620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 BROADWAY ST NE STE 1",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011275",
            "telephone_number": "503-967-6638",
            "fax_number": "503-339-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 BROADWAY ST NE STE 1",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011275",
            "telephone_number": "503-967-6638",
            "fax_number": "503-339-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GOOD PLACE NW, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-30",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "WISSINGER",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-877-8902"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.