Provider Demographics
NPI:1083121859
Name:MUEHLEIP, MAXWELL ELLIOTT (MS, DC)
Entity type:Individual
Prefix:DR
First Name:MAXWELL
Middle Name:ELLIOTT
Last Name:MUEHLEIP
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7880 SW SKYHAR DR.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:503-954-4496
Mailing Address - Fax:
Practice Address - Street 1:9370 SW GREENBURG RD.
Practice Address - Street 2:STE 604 - WASHINGTON BLDG.
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-954-4496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
OR5831111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No111NN1001XChiropractic ProvidersChiropractorNutrition