| Lifestreams Chiropractic Center, Llc | |
|
901 Brutscher St Ste 210 Newberg OR 97132-6094 | |
| (503) 537-2052 | |
| (503) 538-8315 |
| Full Name | Lifestreams Chiropractic Center, Llc |
|---|---|
| Speciality | Chiropractor |
| Location | 901 Brutscher St Ste 210, Newberg, Oregon |
| Authorized Official Name and Position | Mary Ann Tack (CHIROPRACTOR/OWNER) |
| Authorized Official Contact | 5035372052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestreams Chiropractic Center, Llc 901 Brutscher St Ste 210 Newberg OR 97132-6094 Ph: (503) 537-2052 | Lifestreams Chiropractic Center, Llc 901 Brutscher St Ste 210 Newberg OR 97132-6094 Ph: (503) 537-2052 |
| NPI Number | 1942588785 |
|---|---|
| Provider Enumeration Date | 07/27/2011 |
| Last Update Date | 06/19/2020 |
| Medicare PECOS PAC ID | 9436322377 |
|---|---|
| Medicare Enrollment ID | O20111109000428 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942588785 | NPI | - | NPPES |
| 0000QGHFP | Other | OR | MEDICARE ID TYPE UNSPECIFIED |
| 274833 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2863 (Oregon) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Mary Ann Tack |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1346347929 PECOS PAC ID: 4880652817 Enrollment ID: I20041222000427 |
Providence Health & Services - Oregon Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1003 Providence Dr, Suite 325, Newberg, OR 97132 Phone: 503-962-1000 Fax: 503-216-0950 | |
Virginia Garcia Memorial Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2251 E Hancock St Ste 106, Newberg, OR 97132 Phone: 971-281-3050 Fax: 971-281-3051 | |
William M Bailey Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 Villa Rd Ste 114, Newberg, OR 97132 Phone: 503-538-9431 Fax: 503-538-2358 | |
Matthew Frey, L.ac., Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 806 E 1st St, Newberg, OR 97132 Phone: 503-538-7338 Fax: 503-538-7339 | |
Peoples Community Clinic Of Newberg Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1014 N Springbrook Rd Ste B, Newberg, OR 97132 Phone: 503-449-8988 Fax: 503-894-9194 | |
Virginia Garcia Memorial Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2251 E Hancock St, Newberg, OR 97132 Phone: 971-281-3000 Fax: 503-537-0141 | |
Newberg Urgent Care And Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2880 Hayes St, Newberg, OR 97132 Phone: 503-537-9600 Fax: 503-537-0105 |