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Active NPI 1003423914 Organization (Entity Type 2)

Evergreen Chiropractic Pc

Chiropractor • Gresham, OR

Public Directory Information & Medical Disclaimer

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About Evergreen Chiropractic Pc NPI 1003423914 Summary

Evergreen Chiropractic Pc is a verified healthcare organization specializing in Chiropractor operating in Gresham, OR. Located at 657 NE HOOD AVE, this facility provides patient care and medical services under National Provider Identifier (NPI) 1003423914.

Administrative operations and authorized compliance are overseen by Michael Manns (Chiropractor/Owner).

The facility is associated with 4 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

657 Ne Hood Ave

Gresham, OR 970307328

Telephone 5039121156
Fax 9712922932

Authorized Official Information

Authorized Contact Name

DR. Michael Manns , DC

Title / Role

Chiropractor/owner

Official Telephone

5039121156

Facility Classifications & Specialties

Chiropractor Primary Taxonomy

NUCC Taxonomy Code: 111N00000X

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.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

4 Linked
Noran Shamyer , LMT NPI 1114294956

Massage Therapist

Gresham, OR

View Practitioner Profile →

Chiropractor

Gresham, OR

View Practitioner Profile →
Tabitha White , LMT NPI 1669800488

Massage Therapist

Gresham, OR

View Practitioner Profile →

Chiropractor

Gresham, OR

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

7 Historical Events
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Updated Practice Location February 05, 2021

Registered at 657 NE HOOD AVE, GRESHAM, OR 970307328 (Tel: 5038838260)

NPI Profile Active September 24, 2020

NPI status registered as active in NPPES database

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Updated Practice Location September 24, 2020

Registered at 7145 SW VARNS ST STE 203, PORTLAND, OR 972238168 (Tel: 5038838260)

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Updated Business Mailing Address September 24, 2020

Registered at 5920 BURMA RD, LAKE OSWEGO, OR 970353240 (Tel: 9713308017)

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Organization / Clinic Name Updated September 24, 2020

Operating as EVERGREEN CHIROPRACTIC PC

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 24, 2020

Chiropractor

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Initial NPI Registration & Enumeration September 24, 2020

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1003423914
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: September 24, 2020
Last Update: March 05, 2021

Mailing Address

5920 Burma Rd

Lake Oswego, OR 970353240

Phone: 9713308017

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.