KRUSE PARK CHIROPRACTIC LLC
NPI 1700363389
Chiropractor in Lake Oswego, OR

Q: What is Kruse Park Chiropractic LLC's NPI number?

The NPI number for Kruse Park Chiropractic LLC is 1700363389. It was assigned to this organization in the NPPES registry on July 26, 2018.

Q: What is Kruse Park Chiropractic LLC's specialty?

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

Active since July 26, 2018

3990 COLLINS WAY STE 201, LAKE OSWEGO, OR 97035(503) 635-1236 Get Directions Write a Review

NPPES record last updated: July 26, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Kruse Park Chiropractic Llc NPPES

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

KRUSE PARK CHIROPRACTIC LLC (NPI 1700363389) is a healthcare organization registered as a chiropractor in Lake Oswego, Oregon and active in the NPI registry since July 2018. The organization lists Bronwyn Illingworth, Owner, as its authorized official.

NPPES Registry Identity

NPI1700363389

Entity TypeOrganization

Primary Taxonomy111N00000X

Legal Business NameKRUSE PARK CHIROPRACTIC LLC

Location Address3990 COLLINS WAY STE 201Lake Oswego, OR 97035-3459

Mailing AddressPo Box 1609Lake Grove, OR 97035-0809

Phone(503) 635-1236

Organization SubpartNo

Authorized OfficialBronwyn IllingworthOwner · (503) 593-4719

Enumeration DateJuly 26, 2018

✔ NPI 1700363389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in OR · 3897

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.

3990 COLLINS WAY STE 201, Lake Oswego, OR 97035

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kruse Park Chiropractic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Kruse Park Chiropractic LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Jennie-Marie Archambault, DC

Chiropractic

NPI 1043792856

3990 COLLINS WAY
Lake Oswego, OR 97035

(503) 635-1236

✔ Accepts MedicareSame address

Bronwyn Illingworth, D.C.

Chiropractic

NPI 1669709598

3990 COLLINS WAY SUITE 201
Lake Oswego, OR 97035

(503) 635-1236

✔ 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 Kruse Park Chiropractic LLC's NPI number?

The NPI number for Kruse Park Chiropractic LLC is 1700363389. It was assigned to this organization in the NPPES registry on July 26, 2018.

Where is Kruse Park Chiropractic LLC located?

Kruse Park Chiropractic LLC is located at 3990 Collins Way Ste 201, Lake Oswego, OR 97035. The listed phone number is (503) 635-1236.

What is Kruse Park Chiropractic LLC's specialty?

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

Is Kruse Park Chiropractic LLC enrolled in Medicare?

Yes. Kruse Park Chiropractic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kruse Park Chiropractic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Chiropractic, reassign their Medicare billing to Kruse Park Chiropractic LLC. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Kruse Park Chiropractic LLC accept?

Health plans from Moda Health Plan, Inc. list Kruse Park Chiropractic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kruse Park Chiropractic LLC was last updated on July 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.