Provider Demographics
NPI:1265756464
Name:CENTRO CHIROPRACTIC CLINIC OF OREGON LLC
Entity type:Organization
Organization Name:CENTRO CHIROPRACTIC CLINIC OF OREGON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-880-2220
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-0850
Mailing Address - Country:US
Mailing Address - Phone:503-625-0152
Mailing Address - Fax:503-625-0153
Practice Address - Street 1:1585 N PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-3656
Practice Address - Country:US
Practice Address - Phone:503-981-1155
Practice Address - Fax:503-981-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty