Healthcare Provider Details

I. General information

NPI: 1528435385
Provider Name (Legal Business Name): RALEIGH CHRISTINE SEKULIC DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RALEIGH BETH WARREN DC

II. Dates (important events)

Enumeration Date: 08/27/2015
Last Update Date: 02/28/2025
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4412 S BARBUR BLVD SUITE 220
PORTLAND OR
97239
US

IV. Provider business mailing address

4412 S BARBUR BLVD SUITE 220
PORTLAND OR
97239
US

V. Phone/Fax

Practice location:
  • Phone: 503-676-6728
  • Fax: 503-676-3316
Mailing address:
  • Phone: 503-676-6728
  • Fax: 503-676-3316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number5670
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number5670
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5670
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: