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NPI 1104761980

OrganizationActive

Eden Family Wellness Prof Corp

NPI 1104761980 · Pediatric Chiropractor · Portland, OR

Provider details

NPI number: 1104761980
Entity type: Organization
Primary specialty: Pediatric ChiropractorChiropractic Providers
Authorized official: Aesha Marie Carrillo, Owner, Chiropractor

Practice location

5331 S Macadam Ave Ste 285

Portland, OR 97239-3849

Phone: (971) 400-8787

More OR providers

Mailing address

1312 Se Olvera Pl

Gresham, OR 97080-6187

Registry dates

Enumerated: 2026-04-20
Last updated: 2026-05-11

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Eden Family Wellness Prof Corp — NPI 1104761980, Portland, OR | NPI Central