Healthcare Provider Details

I. General information

NPI: 1245779958
Provider Name (Legal Business Name): AMY POHLE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15220 NW GREENBRIER PKWY STE 260
BEAVERTON OR
97006
US

IV. Provider business mailing address

15220 NW GREENBRIER PKWY STE 260
BEAVERTON OR
97006-8111
US

V. Phone/Fax

Practice location:
  • Phone: 562-961-7660
  • Fax: 503-439-9494
Mailing address:
  • Phone: 503-439-9494
  • Fax: 503-645-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number33793
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5581
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5837
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: