REVITALIZE WELLNESS CENTER (NPI# 1215394119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215394119 |
| Entity Type | Organization |
| Organization Name | REVITALIZE WELLNESS CENTER |
| Practice Address |
51577 Columbia River Hwy Suite C Scappoose OR 97056-8409 |
| Mailing Address |
Po Box 1234 Saint Helens OR 97051-8234 |
| Practice Telephone | 5033964807 |
| Practice Fax Number | 5033975373 |
| Mailing Telephone | 5033975211 |
| Mailing Fax Number | 5033975373 |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |
| Authorized Official Name | ROLAND MIGCHIELSEN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5034382201 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLUMBIA COMMUNITY MENTAL HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
OR | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639143647 | Revitalize Wellness Center | Chiropractor | 502 N Ankeny Blvd, Suite 5, Ankeny, IA 50023-1755 | 2006-02-15 |
| Street Address |
51577 COLUMBIA RIVER HWY SUITE C |
| City | SCAPPOOSE |
| State | OR |
| Zip Code | 97056-8409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184607046 | Olya Vasilyevna Kurkoski | Physical Therapist | 51577 Columbia River Hwy, Suite A, Scappoose, OR 97056-8409 | 2005-11-23 |
| 1740759497 | Brandy Estoos | Massage Therapist | 51577 Columbia River Hwy, Scappoose, OR 97056-8409 | 2018-11-23 |
| 1952890311 | Amber Hall | Massage Therapist | 51577 Columbia River Hwy, Scappoose, OR 97056-8409 | 2018-05-01 |
| 1558597732 | Victoria I Smith | Physical Therapist | 51577 Columbia River Hwy, Suite A, Scappoose, OR 97056-8409 | 2009-06-02 |
| 1184696205 | James W Cavin | Physical Therapist | 51577 Columbia River Hwy, Suite A, Scappoose, OR 97056-8409 | 2006-02-02 |
| 1225014517 | Therapeutic Associates Inc | Occupational Therapist | 51577 Columbia River Hwy, Ste A, Scappoose, OR 97056-8409 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780177964 | Gregory Randolph | Physician Assistant | 51377 Sw Old Portland Rd. Suite C, Scappoose, OR 97056 | 2018-06-12 |
| 1356707681 | Bi-mart Corporation | Pharmacy | 51536 Se 2nd Street, Scappoose, OR 97056 | 2015-12-31 |
| 1720326143 | Mark Liu | Pharmacist | 51501 S. Columbia River Hwy, Scappoose, OR 97056 | 2013-01-18 |
| 1114291622 | Oregon Aero, Inc. | Durable Medical Equipment & Medical Supplies | 34020 Skyway Dr., Scappoose, OR 97056 | 2012-03-01 |
| 1619140506 | Scappoose Chiropractic Clinic PC | Clinic/Center | 52481 Sw 1st Street, Scappoose, OR 97056 | 2008-04-11 |
| 1992903454 | Family Vision of Oregon PC | Optometrist | 51675 N Columbia River Hwy, Scappoose, OR 97056 | 2007-07-06 |
| 1265649586 | Hopkins Chiropractic Clinic | Chiropractor | 51669 S. Columbia River Hwy., Suite 130, Scappoose, OR 97056 | 2007-05-17 |
| 1811062706 | Mary Davey Dower | Counselor | 51891 Old Portland Rd, Suite B, Scappoose, OR 97056 | 2006-11-24 |
| 1740378223 | Kendall Rae Liday | Dentist | 33640 E Columbia Ave, Scappoose, OR 97056 | 2006-10-10 |
| 1265533608 | Stephen Frederick Taylor | Dentist | 33454 Havlik Road, Scappoose, OR 97056 | 2006-09-26 |
| Find all providers in zip 97056 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235755596 | Monarch Health and Wellness LLC | Clinic/Center | 4855 River Rd N, Keizer, OR 97303-4537 | 2020-06-23 |
| 1669875480 | Duncan Health Centers, LLC | Clinic/Center | 11900 Sw Beaverton Hillsdale Hwy, Beaverton, OR 97005-2976 | 2014-10-07 |
| 1972813962 | Columbia Pain and Spine Institute | Clinic/Center | 689 Nw Burnside Road, Gresham, OR 97030 | 2010-10-08 |
| 1528067758 | South Eugene Surgi-center, LLC | Clinic/Center | 675 E 19th Ave, Eugene, OR 97401-4304 | 2005-07-19 |
| 1972811842 | Anita J Dekker Md, LLC | Clinic/Center | 3469 Hilyard St, Eugene, OR 97405-3815 | 2010-09-14 |
| 1104064617 | Smj Consulting, Inc | Clinic/Center | 1322 E Mcandrews Rd, Ste 101, Medford, OR 97504-6177 | 2009-01-22 |
| 1861650301 | Integrative Wellness Center, LLC | Clinic/Center | 2343 Se 44th Ave, Portland, OR 97215-3721 | 2008-05-31 |
| 1316104615 | Bend Spine & Pain Specialists, LLC | Clinic/Center | 2041 Ne Williamson Ct, Suite B, Bend, OR 97701-3925 | 2008-05-22 |
| 1538219993 | Northwest Pain Management PC | Clinic/Center | 1322 E Mcandrews Rd, Suite 101, Medford, OR 97504-6177 | 2007-01-10 |
| 1811920366 | Middle Fork Surgery Center LLC | Clinic/Center | 360 S Garden Way, Suite 100, Eugene, OR 97401-8173 | 2006-07-08 |
| Find all providers with the same taxonomy | ||||
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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.