Organization
EASTSIDE WELLNESS CENTER, LLC
Active
Other names
Element Wellness and Sports Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOAH I GOODWILL D.C. (OWNER)
(503) 445-7999
Entity
Organization
Contact information
Practice address
5331 SW MACADAM AVE, SUITE 105, PORTLAND, OR 97239-6104
(503) 445-7999
(503) 445-7997
Mailing address
5331 SW MACADAM AVE, SUITE 105, PORTLAND, OR 97239-6104
(503) 445-7999
(503) 445-7997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3372
OR
225100000X
Physical Therapist
3758
OR
Other
Enumeration date
08/27/2007
Last updated
12/13/2012
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