MEDICARE: PORTLAND SPORTS AND INJURY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	3260	OR

General Provider Information

NPI Number	:	1558586578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORTLAND SPORTS AND INJURY CENTER LLC

Provider Business Mailing Address
First Line	:	4949 MEADOWS RD STE 140
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-3156
Country	:	US
Telephone Number	:	503-305-7244
Fax Number	:	503-305-8849

Provider Business Practice Location Address
First Line	:	4949 MEADOWS RD STE 140
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-3156
Country	:	US
Telephone Number	:	503-305-7244
Fax Number	:	503-305-8849

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. JEFF M ROBINSON
Credential	:	DC
Telephone Number	:	503-305-7244

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	03/20/2024

Similar Medicare Providers

1780901959 — ALICIA M MIRANDA LMT, COTA (RET)
Practice Location Address:

4949 MEADOWS RD STE 140
LAKE OSWEGO, OR
97035-3156

Practice Phone: 503-305-7244
Practice Fax: 503-305-8849

1407082480 — MR. EDWARD CARL GREEN CWOCN
Practice Location Address:

5004 FOOTHILLS RD , APT E
LAKE OSWEGO, OR
97034-3156

Practice Phone: 503-720-9891
Practice Fax:

1326463431 — ALEYSE SWILLING BSSW
Practice Location Address:

6047 LAKE CLUB PL
COLUMBUS, OH
43232-3156

Practice Phone: 614-843-2198
Practice Fax:

1407202989 — JEREMY BURRESS
Practice Location Address:

2451 SEABRING DR
LAKE HAVASU CITY, AZ
86403-3156

Practice Phone: 928-846-6397
Practice Fax:

1356863641 — SAMUEL DAVID TOSTESON LMFT
Practice Location Address:

4711 BALD EAGLE AVE
WHITE BEAR LAKE, MN
55110-3156

Practice Phone: 651-587-7145
Practice Fax:

1104302819 — TIKIA MICHELLE DENT RN
Practice Location Address:

6059 LAKE CLUB PL
COLUMBUS, OH
43232-3156

Practice Phone: 937-840-8003
Practice Fax:

Directions to “PORTLAND SPORTS AND INJURY CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.