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General NPI Number Information
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NPI Number | 1942707393
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Entity Type | Individual
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Provider Name | MICHAEL EMMANUEL SIMELE DC, CCSP, ICSC
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Gender | Male
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 20015 SW PACIFIC HWY STE 302
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City | SHERWOOD
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State | OR
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Zip | 97140-9316
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Country | US
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Telephone | 503-625-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 18019 SW LOWER BOONES FERRY RD
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City | PORTLAND
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State | OR
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Zip | 97224-7228
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Country | US
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Telephone | 503-597-8624
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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 | 5908
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License Number State | OR
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