J M Bussanich, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3853 Issued in OR

Legal business name

J M BUSSANICH, LLC

Doing business as

Westlake Chiropractic

Practice address

14511 Westlake Dr
Suite 148
Lake Oswego, OR 97035-7783

Phone

(503) 620-2353

Fax

(503) 620-4077

NPI assigned

Mar 28, 2012

Last updated

Mar 28, 2012By 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

Dr. Jason Bussanich, D.C.NPI 1174787584

Title

Owner/Provider

Phone

(503) 620-2353

Specialties & licenses 1

Addresses

Other names 1

• Westlake Chiropractic Doing business as

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.

• Jason Mark Bussanich, D.C.

  • Chiropractor
  • Portland, OR
  • NPI 1174787584
  NPD (past) Authorized official

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1760758361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14511 WESTLAKE DR",
            "address_2": "SUITE 148",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357783",
            "telephone_number": "503-620-2353",
            "fax_number": "503-620-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14511 WESTLAKE DR",
            "address_2": "SUITE 148",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357783",
            "telephone_number": "503-620-2353",
            "fax_number": "503-620-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J M BUSSANICH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "BUSSANICH",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "503-620-2353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westlake Chiropractic",
            "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 Mar 28, 2012; 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.