Active NPI
Molly Ouellette, D.C.
- Chiropractor
- Portland, OR
National Provider Identifier
1629390232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3992
- Practice address
- 2024 SE Clinton St
Portland, OR 97202-2245 - Phone
- (503) 238-6262
- Fax
- (503) 473-8047
- NPI assigned
- Feb 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3992 | OR | Primary |
| Chiropractor | 111N00000X | 3327 | MA |
Addresses
Primary practice location
2024 SE Clinton St
Portland, OR 97202-2245
Mailing address
5517 N Commercial Ave
Portland, OR 97217-2339
Phone (503) 223-0900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3327 | MA | MD | Chiropractor |
| 3992 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440979200000",
"number": "1629390232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5517 N COMMERCIAL AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972172339",
"telephone_number": "503-223-0900",
"fax_number": "503-223-1188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2024 SE CLINTON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972022245",
"telephone_number": "503-238-6262",
"fax_number": "503-473-8047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUELLETTE",
"first_name": "MOLLY",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-23",
"last_updated": "2015-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "3992",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "3327",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.