Organization Active NPI

Coyote Resolve

  • Sports Physician Chiropractor
  • Portland, OR
National Provider Identifier
1669095287
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
COYOTE RESOLVE
Doing business as
Coyote Resolve
Practice address
12923 NW Cornell Rd Ste 201
Portland, OR 97229-5834
Phone
(503) 646-3393
NPI assigned
May 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Authorized official

Name
Steve Hanson, DC
Title
Manager
Phone
(503) 956-9065

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X Primary

Addresses

Primary practice location

12923 NW Cornell Rd Ste 201
Portland, OR 97229-5834

Mailing address

14355 SW Rochester Dr
Beaverton, OR 97008-4931

Other names 1

  • Coyote Resolve Doing business as

National Provider Directory

National Provider Directory

Locations

12923 NW Cornell Rd
Ste 201
Portland, OR 97229
Phone (503) 646-3393

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1669095287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14355 SW ROCHESTER DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970084931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12923 NW CORNELL RD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295834",
            "telephone_number": "503-646-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COYOTE RESOLVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-956-9065",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coyote Resolve",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 19, 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.