Organization Active NPI

Scappoose Chiro Clinic LLC

  • Chiropractor
  • Scappoose, OR
National Provider Identifier
1912492570
Registry record updated Jan 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4103 Issued in OR
Legal business name
SCAPPOOSE CHIRO CLINIC LLC
Practice address
33608 E Columbia Ave Ste 110
Scappoose, OR 97056-3442
Phone
(503) 987-4100
Fax
(503) 987-4107
NPI assigned
Jun 26, 2018
Last updated
Jan 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2023

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

Authorized official

Name
Dr. Jamie Marie Ellis, DCNPI 1487771622
Title
Owner
Phone
(503) 987-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4103 OR Primary

Addresses

Primary practice location

33608 E Columbia Ave Ste 110
Scappoose, OR 97056-3442

Mailing address

33608 E Columbia Ave Ste 110
Scappoose, OR 97056-3442
Phone (503) 987-4100

National Provider Directory

National Provider Directory

Locations

33608 E Columbia Ave
Ste 110
Scappoose, OR 97056
Phone (503) 987-4100

Practitioners & affiliated clinicians

Practitioners 3

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": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673136000000",
    "number": "1912492570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33608 E COLUMBIA AVE STE 110",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970563442",
            "telephone_number": "503-987-4100",
            "fax_number": "503-987-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33608 E COLUMBIA AVE STE 110",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970563442",
            "telephone_number": "503-987-4100",
            "fax_number": "503-987-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCAPPOOSE CHIRO CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-01-08",
        "certification_date": "2023-01-08",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-987-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "4103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scappoose, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2023; 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.