Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5831 | OR |
N | 111NN1001X | Nutrition | 5831 | OR |
NPI | 1083121859 |
---|---|
Provider Name | Dr. Maxwell Elliott Muehleip |
First Address | Portland, OR 97225-5105 |
Second Address | Portland, OR 97225-5105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2018 |
Last Update Date | 28/04/2021 |