Organization
GREENWAY CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W BREITENSTEIN DC (OWNER)
(503) 643-0156
Entity
Organization
Contact information
Practice address
8070 SW HALL BLVD, SUITE 100, BEAVERTON, OR 97008-6419
(503) 643-0156
(971) 732-5624
Mailing address
8070 SW HALL BLVD, SUITE 100, BEAVERTON, OR 97008-6419
(503) 643-0156
(971) 732-5624
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1508
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R0000QGBXK
MEDICARE PTAN
OR
Enumeration date
06/21/2012
Last updated
06/21/2012
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