MEDICARE: AXIS HEATHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1073762449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AXIS HEATHCARE

Provider Business Mailing Address
First Line	:	10175 SW BARBUR BLVD
Second Line	:	SUITE 105BA
City	:	PORTLAND
State	:	OR
Zip	:	97219-5908
Country	:	US
Telephone Number	:	503-245-4100
Fax Number	:	503-245-4722

Provider Business Practice Location Address
First Line	:	10175 SW BARBUR BLVD
Second Line	:	SUITE 105BA
City	:	PORTLAND
State	:	OR
Zip	:	97219-5908
Country	:	US
Telephone Number	:	503-245-4100
Fax Number	:	503-245-4722

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL D BEEBE
Credential	:	DC
Telephone Number	:	503-245-4100

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	09/10/2008

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Directions to “AXIS HEATHCARE ” Practice Location

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