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General NPI Number Information
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NPI Number | 1417382946
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Entity Type | Individual
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Provider Name | JUSTIN KNIGHT D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 2035 SE BELMONT ST
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City | PORTLAND
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State | OR
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Zip | 97214-2812
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Country | US
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Telephone | 503-502-3124
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Fax |
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Provider Business Mailing Address
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Address Line | 3736 NE CLEVELAND AVE
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City | PORTLAND
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State | OR
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Zip | 97212-1001
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Country | US
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Telephone | 971-373-5078
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5500
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License Number State | OR
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