Healthcare Provider Details

I. General information

NPI: 1821977372
Provider Name (Legal Business Name): PORTLAND CHIROPRACTORS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2175 NW RALEIGH ST STE 102
PORTLAND OR
97210-2392
US

IV. Provider business mailing address

2440 SE 89TH AVE STE 1
PORTLAND OR
97216-2053
US

V. Phone/Fax

Practice location:
  • Phone: 503-593-1527
  • Fax:
Mailing address:
  • Phone: 503-593-1527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXIS LEE
Title or Position: PRESIDENT
Credential: DC
Phone: 503-593-1527