Healthcare Provider Details

I. General information

NPI: 1326258492
Provider Name (Legal Business Name): JOHN L V PLATT, DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8029 SE WOODSTOCK BLVD
PORTLAND OR
97206-5885
US

IV. Provider business mailing address

8029 SE WOODSTOCK BLVD
PORTLAND OR
97206-5885
US

V. Phone/Fax

Practice location:
  • Phone: 503-774-1776
  • Fax: 503-777-4211
Mailing address:
  • Phone: 503-774-1776
  • Fax: 503-777-4211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number272430
License Number StateOR

VIII. Authorized Official

Name: DR. JOHN L V PLATT
Title or Position: PRESIDENT
Credential: DC
Phone: 503-774-1776