Injury and Trauma Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INJURY AND TRAUMA CLINIC LLC

Practice address

12774 SE Stark St
Portland, OR 97233-1539

Phone

(971) 254-8909

Fax

(971) 347-3104

NPI assigned

Dec 6, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Volodymyr Golovan

Title

Manager

Phone

(971) 254-8909

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1607212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607212800000",
    "number": "1932705969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12774 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "971-254-8909",
            "fax_number": "971-347-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12774 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "971-254-8909",
            "fax_number": "971-347-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INJURY AND TRAUMA CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-06",
        "last_updated": "2020-12-06",
        "certification_date": "2020-12-05",
        "status": "A",
        "authorized_official_last_name": "GOLOVAN",
        "authorized_official_first_name": "VOLODYMYR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "971-254-8909",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hugo Bernard Ings, CADC II
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• Soledad Grefnes Iniguez, WHCNP
• Kalpana Rejina Injety, D.O.
• Sabina Inkumsah, RBAI
• Paula Inman-Balanzar, MS
• Charles Inman, BC-HIS
• Megan Beth Inman
• Monet Brice Inman

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.