Active NPI
Coyote Resolve
- Sports Physician Chiropractor
- Portland, OR
National Provider Identifier
1669095287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | |||
| Sports Physician Chiropractor | 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
National Provider Directory
National Provider DirectoryLocations
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.