Provider Demographics
NPI:1942707393
Name:SIMELE, MICHAEL EMMANUEL (DC, CCSP, ICSC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EMMANUEL
Last Name:SIMELE
Suffix:
Gender:M
Credentials:DC, CCSP, ICSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18019 SW LOWER BOONES FERRY RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97224-7228
Mailing Address - Country:US
Mailing Address - Phone:503-597-8624
Mailing Address - Fax:
Practice Address - Street 1:20015 SW PACIFIC HWY STE 302
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9316
Practice Address - Country:US
Practice Address - Phone:503-625-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor