Kelly Yakiwchuk, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3347 Issued in OR

Practice address

12615 NE Halsey St
Portland, OR 97230-1930

Phone

(971) 377-1717

NPI assigned

Mar 30, 2007

Last updated

Oct 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capitano Chiropractic, PCGroup PAC ID 5890820518, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capitano Chiropractic, PC

  • Chiropractor
  • Portland, OR
  • NPI 1760651830
  Medicare reassignment Care Compare group NPD
• Valleyview Injury & Physical Medicine, PC

  • Public Health & General Preventive Medicine Physician
  • Gresham, OR
  • NPI 1174997423
  Medicare reassignment

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1558481895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 SE STEELE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972065459",
            "telephone_number": "971-500-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 NE HALSEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301930",
            "telephone_number": "971-377-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKIWCHUK",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yakima Valley Farm Workers Clinic (Rosewood Family Health at Gateway)
• Yakima Valley Farm Workers Clinic (Rosewood Family Health at Lents)
• Yakima Valley Farm Workers Clinic (Rosewood Family Health Center Pharmacy)
• Yakima Valley Farm Workers Clinic (Rosewood Family Health Center)
• Yakima Valley Farm Workers Clinic (Rosewood Family Health Center Dental)
• Aded Yako
• Deana Yakymchuk
• Yale S. Popowich, M.D., P.C.
• Samuel Yale, DVM
• King Chung Yam, MD

• Chiropractor in Portland, OR
• Providers in Portland, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.