Wellness Way Beaverton LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WELLNESS WAY BEAVERTON LLC

Practice address

12655 SW Center St Ste 145
Beaverton, OR 97005-1864

Phone

(971) 727-8965

NPI assigned

Mar 24, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Stepphine Tilden, DC

Title

Owner

Phone

(971) 727-8965

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1780211391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12655 SW CENTER ST STE 145",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051864",
            "telephone_number": "971-727-8965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 SW CENTER ST STE 145",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051864",
            "telephone_number": "971-727-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS WAY BEAVERTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "TILDEN",
        "authorized_official_first_name": "STEPPHINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-727-8965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kenneth Alan Wells, L.MT.
• Larrisha Wells

• Chiropractor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.