Provider Demographics
NPI:1982492872
Name:PADILLA CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:PADILLA CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-967-8568
Mailing Address - Street 1:289 E ELLENDALE AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-1559
Mailing Address - Country:US
Mailing Address - Phone:503-967-8568
Mailing Address - Fax:
Practice Address - Street 1:289 E ELLENDALE AVE STE 701
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-1559
Practice Address - Country:US
Practice Address - Phone:503-967-8568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty