FORM & FUNCTION CHIROPRACTIC PC
NPI 1033072251
Chiropractor in Lake Oswego, OR

Q: What is Form & Function Chiropractic PC's NPI number?

The NPI number for Form & Function Chiropractic PC is 1033072251. It was assigned to this organization in the NPPES registry on December 4, 2025. The provider is doing business as Form & Function Chiropractic.

Q: What is Form & Function Chiropractic PC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Active since December 04, 2025

3 MONROE PKWY STE G, LAKE OSWEGO, OR 97035(503) 495-3454 Get Directions Write a Review

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 18, 2025, Dec 4, 2025 (2 updates tracked since 2025).

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About Form & Function Chiropractic Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORM & FUNCTION CHIROPRACTIC PC (NPI 1033072251), doing business as Form & Function Chiropractic, is a healthcare organization registered as a chiropractor in Lake Oswego, Oregon and active in the NPI registry since December 2025. The organization lists Jeff Devine, Partner/dr, as its authorized official.

NPPES Registry Identity

NPI1033072251

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameFORM & FUNCTION CHIROPRACTIC PC

Location Address3 MONROE PKWY STE GLake Oswego, OR 97035-8874

Mailing Address3 Monroe Pkwy Ste GLake Oswego, OR 97035-8874 · (503) 495-3454

Phone(503) 495-3454

Organization SubpartNo

Authorized OfficialJeff DevinePartner/dr · (503) 330-3289

Enumeration DateDecember 4, 2025

Last NPPES UpdateDecember 18, 20252 updates tracked since enumeration

NPPES CertifiedDecember 18, 2025

✔ NPI 1033072251 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

3 MONROE PKWY STE G, Lake Oswego, OR 97035

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Other Names 1

Doing Business AsForm & Function Chiropractic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Form & Function Chiropractic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Form & Function Chiropractic PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jeffrey Devine, D.C.

Chiropractic

NPI 1174667356

3 MONROE PKWY STE G
Lake Oswego, OR 97035

(503) 495-3454

✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Form & Function Chiropractic PC's NPI number?

The NPI number for Form & Function Chiropractic PC is 1033072251. It was assigned to this organization in the NPPES registry on December 4, 2025. The provider is doing business as Form & Function Chiropractic.

Where is Form & Function Chiropractic PC located?

Form & Function Chiropractic PC is located at 3 Monroe Pkwy Ste G, Lake Oswego, OR 97035. The listed phone number is (503) 495-3454.

What is Form & Function Chiropractic PC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Form & Function Chiropractic PC enrolled in Medicare?

Yes. Form & Function Chiropractic PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Form & Function Chiropractic PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Form & Function Chiropractic PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Form & Function Chiropractic PC was last updated on December 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.