# OREGON REGENERATION STEM CELL MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275027393
- **Authorized official:** RICHARD ALAN SHAW DC (OWNER)
- **Authorized official phone:** (614) 507-7799

## Contact information

- **Practice address:** 29781 SW TOWN CENTER LOOP, WILSONVILLE, OR 97070
- **Practice address phone:** (971) 533-6636
- **Practice address fax:** (740) 450-2494
- **Mailing address:** 29781 SW TOWN CENTER LOOP, WILSONVILLE, OR 97070
- **Mailing address phone:** (971) 313-4195
- **Mailing address fax:** (740) 450-2494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | Yes |
| 367A00000X | Advanced Practice Midwife | — | — | Yes |

## Other

- **Enumeration date:** 06/21/2018
- **Last updated:** 06/21/2018