NPIMap

Organization Active NPI

Manual Medicine & Rehabilitation Center PC, of Wa

Doing business as Dr. Ibolit

  • Chiropractor
  • Portland, OR
National Provider Identifier
1831793603
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MANUAL MEDICINE & REHABILITATION CENTER PC, OF WA
Doing business as
Dr. Ibolit
Practice address
18633 SE Stark St BLDG a
Portland, OR 97233-5468
Phone
(360) 737-9665
NPI assigned
Nov 23, 2020
Last updated
Jun 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Aldona L PattersonNPI 1023826401
Title
Billing
Phone
(360) 737-9665

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

18633 SE Stark St BLDG a
Portland, OR 97233-5468

Mailing address

18633 SE Stark St BLDG a
Portland, OR 97233-5468
Phone (360) 737-9665

Other names 1

  • Dr. Ibolit Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address billing@dribolit.com Direct

National Provider Directory

National Provider Directory

Locations

18633 SE Stark St
Bldg A
Portland, OR 97233
Phone (360) 737-9665

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1831793603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18633 SE STARK ST BLDG A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335468",
            "telephone_number": "360-737-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18633 SE STARK ST BLDG A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335468",
            "telephone_number": "360-737-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUAL MEDICINE & REHABILITATION CENTER PC, OF WA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "ALDONA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "360-737-9665"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@dribolit.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "18633 SE Stark St Bldg A",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972335468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Dr. Ibolit",
            "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 Jun 8, 2021; 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.