NPIMap

Organization Active NPI

Pro Wellness Chiropractic, LLC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1740794478
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5871 Issued in OR
Legal business name
PRO WELLNESS CHIROPRACTIC, LLC
Practice address
865 NE Tomahawk Island Dr # 102-306
Portland, OR 97217-8095
Phone
(971) 770-2204
Fax
(503) 336-1033
NPI assigned
Nov 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Authorized official

Name
Karina Donskoy, DCNPI 1902312861
Title
President
Phone
(971) 770-2204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5871 OR Primary

Addresses

Primary practice location

865 NE Tomahawk Island Dr # 102-306
Portland, OR 97217-8095

Mailing address

865 NE Tomahawk Island Dr # 102-306
Portland, OR 97217-8095
Phone (971) 770-2204

National Provider Directory

National Provider Directory

Locations

865 NE Tomahawk Island Dr
#102306
Portland, OR 97217
Phone (971) 770-2204

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": "1510790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510790400000",
    "number": "1740794478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 NE TOMAHAWK ISLAND DR # 102-306",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972178095",
            "telephone_number": "971-770-2204",
            "fax_number": "503-336-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 NE TOMAHAWK ISLAND DR # 102-306",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972178095",
            "telephone_number": "971-770-2204",
            "fax_number": "503-336-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO WELLNESS CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A",
        "authorized_official_last_name": "DONSKOY",
        "authorized_official_first_name": "KARINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "971-770-2204",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5871",
            "primary": true
        }
    ],
    "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 Nov 16, 2017; 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.