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General NPI Number Information
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NPI Number | 1578947412
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Entity Type | Organization
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Legal Business Name | J2.0, LLC
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 8835 SW CANYON LN STE 120
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City | PORTLAND
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State | OR
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Zip | 97225-3451
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Country | US
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Telephone | 971-348-3710
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Fax | 971-348-3711
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Provider Business Mailing Address
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Address Line | 8835 SW CANYON LN STE 120
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City | PORTLAND
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State | OR
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Zip | 97225-3451
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Country | US
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Telephone | 971-348-3710
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Fax | 971-348-3711
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Authorized Official
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Title or Position | MEMBER
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Name | JOAN O'CONNOR
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Credential | D.C.
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Telephone | 971-348-3710
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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 | 3066
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License Number State | OR
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