Healthcare Provider Details

I. General information

NPI: 1447040423
Provider Name (Legal Business Name): WILKES FAMILY INVESTMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 E BURNSIDE ST STE 213
PORTLAND OR
97214-1768
US

IV. Provider business mailing address

2705 E BURNSIDE ST STE 213
PORTLAND OR
97214-1768
US

V. Phone/Fax

Practice location:
  • Phone: 503-234-4288
  • Fax:
Mailing address:
  • Phone: 503-234-4288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: PETER BRIAN WILKES
Title or Position: OWNER
Credential: DC
Phone: 503-234-4288