Healthcare Provider Details

I. General information

NPI: 1932530003
Provider Name (Legal Business Name): VALLEYVIEW CHIROPRACTIC AND SPINE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2013
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 SE POWELL VALLEY RD SUITE 205
GRESHAM OR
97080-1494
US

IV. Provider business mailing address

2850 SE POWELL VALLEY RD SUITE 205
GRESHAM OR
97080-1494
US

V. Phone/Fax

Practice location:
  • Phone: 503-489-1998
  • Fax: 503-489-1975
Mailing address:
  • Phone: 503-489-1998
  • Fax: 503-489-1975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. BENJAMIN HEATH
Title or Position: OWNER
Credential: DC
Phone: 503-489-1998