Individual provider Active NPI

Ralph Ezagui, D.C.

  • Chiropractor
  • West Linn, OR
National Provider Identifier
1760580138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27 3058 Issued in OR
Practice address
21860 Willamette Dr
West Linn, OR 97068-3256
Phone
(503) 650-2394
Fax
(503) 905-6180
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27 3058 OR Primary

Addresses

Primary practice location

21860 Willamette Dr
West Linn, OR 97068-3256

Mailing address

21860 Willamette Dr
West Linn, OR 97068-3256
Phone (503) 650-2394

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

LicenseStateTypeSpecialty
27 3058ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Core Movement Chiropractic LLC Chiropractor CurrentSince Nov 17, 2024 Accepting new patients

Locations

21860 Willamette Dr
West Linn, OR 97068
Phone (503) 650-2394

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760580138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21860 WILLAMETTE DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683256",
            "telephone_number": "503-650-2394",
            "fax_number": "503-905-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21860 WILLAMETTE DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683256",
            "telephone_number": "503-650-2394",
            "fax_number": "503-905-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZAGUI",
        "first_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27 3058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.