Organization Active NPI

Back to Life Chiropractic

  • Chiropractor
  • Portland, OR
National Provider Identifier
1922536739
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BACK TO LIFE CHIROPRACTIC
Practice address
9515 SW Barbur Blvd
Portland, OR 97219-5414
Phone
(503) 206-8642
Fax
(503) 327-8834
NPI assigned
May 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Dr. Ali Khoshbin, DCNPI 1134488257
Title
Owner
Phone
(503) 206-8642

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 1

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

Addresses

Primary practice location

9515 SW Barbur Blvd
Portland, OR 97219-5414

Mailing address

251 SW Alder St
Portland, OR 97204-3105
Phone (503) 206-8642

National Provider Directory

National Provider Directory

Locations

251 SW Alder St
Portland, OR 97204
Phone (818) 669-0892

9515 SW Barbur Blvd
Portland, OR 97219
Phone (503) 206-8642

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1922536739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SW ALDER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972043105",
            "telephone_number": "503-206-8642",
            "fax_number": "503-327-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 SW BARBUR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195414",
            "telephone_number": "503-206-8642",
            "fax_number": "503-327-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO LIFE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-24",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "KHOSHBIN",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-206-8642",
        "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": []
}

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 Oct 21, 2024; 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.