TIM GALLUCCI (NPI# 1154795268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154795268 |
| Entity Type | Individual |
| Full Name | TIM GALLUCCI |
| Credential | DC |
| Practice Address |
4112 Ne 79th Ave Portland OR 97218-4202 |
| Practice Telephone | 6502234707 |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 5691 | OR | Chiropractic Providers |
| Street Address |
4112 NE 79TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97218-4202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043852726 | Alex Margarito | Specialist/Technologist | 6801 Necornfoot Rd, Fpo, AA 97218 | 2019-10-14 |
| 1083101943 | Joyce M Larkins | Specialist | 5852 Ne 42nd Ave., Portland, OR 97218 | 2018-04-17 |
| 1740709658 | Alyssa M Cavalier | Licensed Practical Nurse | 6601 Ne 78th Ct., Suite A3, Portland, OR 97218 | 2017-09-12 |
| 1093266405 | Jean Hansen | Counselor | 6601ne 78th Court Suite, Suite A3, Portland, OR 97218 | 2016-10-20 |
| 1174913636 | Kirsten Kelly-chambers | Counselor | 4310 Ne Killinsworth Street, Portland, OR 97218 | 2015-02-04 |
| 1386962074 | Kathleen Kuhlmey Sheridan | Nurse Practitioner | 5215 Ne 52nd Ave, Portland, OR 97218 | 2010-05-06 |
| 1003049909 | Kevin Richardson | Adult Companion | 5029 Ne Killingsworth St, Portland, OR 97218 | 2009-08-26 |
| 1366676462 | Bobbi Gabriele Kennedy | Military Health Care Provider | 6801 Ne Cornfoot Road, Portland, OR 97218 | 2009-05-05 |
| 1396980751 | Jamie Mercile Taylor | Counselor | 4310 N.e Kilingsworth, Portland, OR 97218 | 2008-12-12 |
| 1902041460 | Brandi Danielle Hess | Counselor | 4450 Ne 76th, Portland, OR 97218 | 2008-12-11 |
| Find all providers in zip 97218 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486958 | Amy Elizabeth Goebel | Chiropractor | 5103 Se Stark St Apt B, Portland, OR 97215-1764 | 2020-10-27 |
| 1003423914 | Evergreen Chiropractic PC | Chiropractor | 7145 Sw Varns St Ste 203, Portland, OR 97223-8168 | 2020-09-24 |
| 1750993283 | University of Western States Healthcare Inc | Chiropractor | 8000 Ne Tillamook St, Portland, OR 97213-6655 | 2020-08-17 |
| 1518587989 | Kristy Pearl Arneson | Chiropractor | 3715 Se Cesar E Chavez Blvd, Portland, OR 97202-1704 | 2020-04-25 |
| 1770102956 | Behireta Corbadzic | Chiropractor | 12923 Se Foster Rd Unit G703, Portland, OR 97236-4702 | 2020-04-08 |
| 1134754427 | Bonnie Anderson | Chiropractor | 3539 N Williams Ave Ste 202a, Portland, OR 97227-1437 | 2020-03-06 |
| 1629601372 | Megan Adele Robles | Chiropractor | 2100 Ne Broadway St Ste 255, Portland, OR 97232-1544 | 2020-02-20 |
| 1306479472 | Naomi M Enos-burles | Chiropractor | 7332 Sw 13th Dr Apt A, Portland, OR 97219-2089 | 2020-02-18 |
| 1184256927 | Michael Nicosia | Chiropractor | 207 Santa Monica St, Portland, TX 78374-2645 | 2020-02-10 |
| 1942832258 | Tracy Yvonne Still | Chiropractor | 3905b Ne Grand Ave Unit B, Portland, OR 97212-1107 | 2020-02-05 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.