Organization
ACTIVE WELLNESS CHIROPRACTIC,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEGAN DEJANA D.C. (CEO)
(503) 789-1014
Entity
Organization
Contact information
Practice address
1815 SW MARLOW AVE, SUITE 206, PORTLAND, OR 97225-5185
(503) 789-1014
(877) 985-9111
Mailing address
1815 SW MARLOW AVE, SUITE 206, PORTLAND, OR 97225-5185
(503) 789-1014
(877) 985-9111
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3632
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871506600
NPI TYPE 1
OR
Enumeration date
08/19/2014
Last updated
08/19/2014
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