# PORTLAND CHIROPRACTIC GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Portland Chiropractic Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134393556
- **Authorized official:** DR. RANDY L HEWITT D.C., C.C.S.P. (DOCTOR OF CHIROPRACTIC/OWNER)
- **Authorized official phone:** (503) 224-2100

## Contact information

- **Practice address:** 2031 E BURNSIDE ST, PORTLAND, OR 97214-1649
- **Practice address phone:** (503) 224-2100
- **Practice address fax:** (503) 224-2129
- **Mailing address:** 2031 E BURNSIDE ST, PORTLAND, OR 97214-1649
- **Mailing address phone:** (503) 224-2100
- **Mailing address fax:** (503) 224-2129

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 2343 | OR | Yes |
| 111NP0017X | Pediatric Chiropractor | 27 2473 | OR | — |
| 171100000X | Acupuncturist | 1527 | OR | — |
| 225700000X | Massage Therapist | 7732 | OR | — |

## Other

- **Enumeration date:** 04/16/2008
- **Last updated:** 01/06/2010