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Organization
MIND & BODY WELLNESS OF BEAVERTON
Active
Organization
MIND & BODY WELLNESS OF BEAVERTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER KENT STEWART DC (CHIROPRACTIC PHYSICIAN)
(503) 891-1389
Entity
Organization
Contact information
Practice address
4545 SW ANGEL AVE APT 108, BEAVERTON, OR 97005-2717
(503) 891-1389
Mailing address
4545 SW ANGEL AVE APT 108, BEAVERTON, OR 97005-2717
(503) 891-1389
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
NULL
111N00000X
Chiropractor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500740983
—
OR
01
—
5857
STATE CHIROPRACTIC LICENSE
OR
01
—
R4317
LICENSE NUMBER
OR
Enumeration date
10/29/2018
Last updated
10/29/2018
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