Jan L Bender, D.C.
Individual provider Active NPI Chiropractor · Portland, OR
NPI 1992842124 · NPPES record last updated Apr 5, 2011
Key facts
- NPI
- 1992842124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 27 3168 (OR)
- Practice address
- 1201 SW 12TH Ave Ste 600
Portland, OR 97205-2034 - Phone
- (503) 224-2425
- Fax
- (503) 224-7512
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- PDX Bodyworks Physical Therapy
Practice addresses (Care Compare)
1818 NE M L King Blvd
Suite C
Portland, OR 97212-3976
Phone (971) 267-3978
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120105000898 | OR | Practitioner - Chiropractic | 8224204672 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27 3168 | OR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PDX Bodyworks Physical Therapy | Current |
Accepting new patients |
Locations
1818 NE Mlk Jr Blvd
Ste C
Portland, OR 97212
Phone (503) 206-8988
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 27 3168 | OR | Yes |
Addresses
Primary practice location
1201 SW 12TH Ave Ste 600
Portland, OR 97205-2034
Mailing address
1201 SW 12TH Ave Ste 600
Portland, OR 97205-2034
Phone (503) 224-2425
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.