NPI 1003679200 · live from the CMS NPI Registry
Active Injury Rehab, LLC
Chiropractor in Portland, OR. National Provider Identifier 1003679200, active.
NPI record
| NPI | 1003679200 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 5253 Ne Sandy Blvd, Portland, OR 97213 |
| Practice phone | 503-766-4881 |
| Mailing address | 1605 Ne 51st Ave, Portland, OR 97213 |
| Enumerated | February 1, 2024 |
| Last updated | February 1, 2024 |
| Authorized official | Keenan Borgardt, Owner |
| Other names | Cascade Spine & Injury Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acupuncturist | 171100000X | — |
| Massage Therapist | 225700000X | — |
| Chiropractor primary | 111N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.