MILWAUKIE SPINE AND SPORT, LLC (NPI# 1679850010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679850010 |
| Entity Type | Organization |
| Organization Name | MILWAUKIE SPINE AND SPORT, LLC |
| Practice Address |
2100 Se Lake Rd Suite 1 Milwaukie OR 97222-7759 |
| Practice Telephone | 5033446711 |
| Practice Fax Number | 5039269365 |
| Mailing Telephone | 5033446711 |
| Mailing Fax Number | 5039269365 |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2013-06-24 |
| Authorized Official Name | DR. KAREN BARANICK (CHIROPRACTOR/OWNER) |
| Authorized Official Telephone | 5033446711 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
3998 | OR | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MILWAUKIE SPINE AND SPORT, LLC | 2100 Se Lake Rd, Suite 1, Milwaukie, OR 97222 |
| Street Address |
2100 SE LAKE RD SUITE 1 |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-7759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992860803 | Justin C O'hanlon | Social Worker | 2100 Se Lake Rd, #2a, Milwaukie, OR 97222-7759 | 2006-12-22 |
| 1528313814 | Mary Florence Boyd | Specialist | 2100 Se Lake Rd, Milwaukie, OR 97222-7759 | 2012-07-23 |
| 1245509132 | Kathryn Shires | Massage Therapist | 2100 Se Lake Rd, Suite One, Milwaukie, OR 97222-7759 | 2011-12-21 |
| 1780990630 | Michelle Denise Roberts | Massage Therapist | 2100 Se Lake Rd, Suite 2b, Milwaukie, OR 97222-7759 | 2010-08-28 |
| 1073833562 | Michelle D Dusek | Massage Therapist | 2100 Se Lake Rd, Suite 2b, Milwaukie, OR 97222-7759 | 2010-06-07 |
| 1295066504 | Karen Baranick | Chiropractor | 2100 Se Lake Rd, Suite 1, Milwaukie, OR 97222-7759 | 2010-01-26 |
| 1346485711 | Thomas E Hogan | Social Worker | 2100 Se Lake Rd, Suite 4, Milwaukie, OR 97222-7759 | 2008-12-12 |
| 1346440070 | Eric F. Nielson | Marriage & Family Therapist | 2100 Se Lake Rd, Suite 4, Milwaukie, OR 97222-7759 | 2007-07-20 |
| 1639394075 | Thomas Lehman Gritzka | Specialist | 2100 Se Lake Rd, Suite 6, Milwaukie, OR 97222-7759 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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|---|---|---|---|---|
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| 1407492002 | Oregon Injection Clinic | Clinic/Center | 1500 Nw Lovejoy, 106, Portland, OR 97209 | 2019-11-19 |
| 1801452818 | Everybody Wellness, LLC | Clinic/Center | 2143 Ne Broadway St Ste 9, Portland, OR 97232-1512 | 2019-05-15 |
| 1801451737 | Cephus Chiropractic LLC | Clinic/Center | 19755 Sw Tv Hwy, Aloha, OR 97003-2338 | 2019-05-06 |
| 1467934661 | Columbia River Health-pendleton High School Sbhc | Clinic/Center | 1800 Nw Carden Ave, Pendleton, OR 97801-1185 | 2018-09-04 |
| 1639651839 | Columbia River Health-sunridge Middle School Sbhc | Clinic/Center | 700 Sw Runnion Ave, Pendleton, OR 97801-9418 | 2018-09-04 |
| 1114433802 | Thriving Acupuncture | Clinic/Center | 1708 Nw 25th Ave Apt 6, Portland, OR 97210-2435 | 2017-12-18 |
| 1538681408 | Golden Ribbon Acupuncture, LLC | Clinic/Center | 1217 Ne Burnside Rd Ste 701, Gresham, OR 97030-5770 | 2017-07-12 |
| 1316468341 | Accident Care Chiropractic and Massage of Salem | Clinic/Center | 2168 Lancaster Dr. Ne, Portland, OR 97216 | 2017-06-29 |
| 1417484460 | Be Well Acupuncture | Clinic/Center | 3125 Ne Holladay St # B, Portland, OR 97232-2504 | 2017-05-20 |
| 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.