Organization
D'VIDA INJURY CLINIC & WELLNESS CENTER LLC
Active
Other names
D'Vida Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE WHITTAKER LAC (OWNER)
(503) 626-2166
Entity
Organization
Contact information
Practice address
14195 SW ALLEN BLVD, BEAVERTON, OR 97005-4408
(503) 626-2166
(503) 641-6665
Mailing address
14195 SW ALLEN BLVD, BEAVERTON, OR 97005-4408
(503) 626-2166
(503) 641-6665
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4077
OR
171100000X
Acupuncturist
AC01279
OR
Other
Enumeration date
06/08/2012
Last updated
06/27/2014
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