Healthcare Provider Details

I. General information

NPI: 1083121859
Provider Name (Legal Business Name): MAXWELL ELLIOTT MUEHLEIP MS, DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9370 SW GREENBURG RD. STE 604 - WASHINGTON BLDG.
TIGARD OR
97223
US

IV. Provider business mailing address

7880 SW SKYHAR DR.
PORTLAND OR
97223
US

V. Phone/Fax

Practice location:
  • Phone: 503-954-4496
  • Fax:
Mailing address:
  • Phone: 503-954-4496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number5831
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5831
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: