Kathleen M Galligan

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

27-1674 Issued in OR

Legal business name

KATHLEEN M GALLIGAN

Doing business as

Kruse Park Chiropractic Clinic

Practice address

3990 Collins Way
Suite #201
Lake Oswego, OR 97035-3480

Phone

(503) 635-1236

Fax

(503) 597-4741

NPI assigned

Jan 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Wakeman

Title

Manager

Phone

(503) 635-1236

Specialties & licenses 1

Addresses

Other names 1

• Kruse Park Chiropractic Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathleen Marie Galligan, DC

  • Chiropractor
  • Lake Oswego, OR
  • NPI 1053395632
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659426625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 COLLINS WAY",
            "address_2": "SUITE #201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353480",
            "telephone_number": "503-635-1236",
            "fax_number": "503-597-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 COLLINS WAY",
            "address_2": "SUITE #201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353480",
            "telephone_number": "503-635-1236",
            "fax_number": "503-597-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN M GALLIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAKEMAN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-635-1236"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27-1674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kruse Park Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Aug 22, 2020; 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.