NPIMap

Organization Active NPI

Wilsonville Chiropractic Clinic, P.C.

  • Chiropractor
  • Wilsonville, OR
National Provider Identifier
1851533087
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1544 Issued in OR
Legal business name
WILSONVILLE CHIROPRACTIC CLINIC, P.C.
Practice address
30045 SW Parkway Ave
Wilsonville, OR 97070-9735
Phone
(503) 682-9046
Fax
(503) 682-9046
NPI assigned
Apr 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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

Authorized official

Name
Dr. Dale Burt Johnston, D.C.
Title
Ceo
Phone
(503) 682-9046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1544 OR Primary

Addresses

Primary practice location

30045 SW Parkway Ave
Wilsonville, OR 97070-9735

Mailing address

PO Box 691
Wilsonville, OR 97070-0691
Phone (503) 682-9046

National Provider Directory

National Provider Directory

Locations

30045 SW Parkway Ave
Wilsonville, OR 97070
Phone (503) 682-2455

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1851533087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970700691",
            "telephone_number": "503-682-9046",
            "fax_number": "503-682-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30045 SW PARKWAY AVE",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709735",
            "telephone_number": "503-682-9046",
            "fax_number": "503-682-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSONVILLE CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "BURT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-682-9046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "1544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.