Healthcare Provider Details

I. General information

NPI: 1861371643
Provider Name (Legal Business Name): JOSEPH HAAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 NW EASTMAN PKWY STE 265
GRESHAM OR
97030-3860
US

IV. Provider business mailing address

4822 SW 35TH PL
PORTLAND OR
97221-3905
US

V. Phone/Fax

Practice location:
  • Phone: 150-366-9196
  • Fax:
Mailing address:
  • Phone: 760-978-5866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number013718
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6465
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: