| Mind & Body Wellness Of Beaverton | |
|
4545 Sw Angel Ave Apt 108 Beaverton OR 97005-2717 | |
| (503) 891-1389 | |
| Not Available |
| Full Name | Mind & Body Wellness Of Beaverton |
|---|---|
| Speciality | Chiropractor |
| Location | 4545 Sw Angel Ave Apt 108, Beaverton, Oregon |
| Authorized Official Name and Position | Christopher Kent Stewart (CHIROPRACTIC PHYSICIAN) |
| Authorized Official Contact | 5038911389 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind & Body Wellness Of Beaverton 4545 Sw Angel Ave Apt 108 Beaverton OR 97005-2717 Ph: (503) 891-1389 | Mind & Body Wellness Of Beaverton 4545 Sw Angel Ave Apt 108 Beaverton OR 97005-2717 Ph: (503) 891-1389 |
| NPI Number | 1588131411 |
|---|---|
| Provider Enumeration Date | 10/29/2018 |
| Last Update Date | 10/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588131411 | NPI | - | NPPES |
| 500740983 | Medicaid | OR | |
| 5857 | Other | OR | STATE CHIROPRACTIC LICENSE |
| R4317 | Other | OR | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
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