Eden Family Wellness Prof Corp
NPI 1104761980ActiveOrganization· Chiropractor, Pediatric Chiropractor· Portland, OR
Chiropractor, Pediatric Chiropractor in Portland, Oregon, registered in NPPES in April 2026. The authorized official on file is Aesha Marie Carrillo, DC, Owner, Chiropractor. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104761980 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 20, 2026 |
| Last updated in NPPES | May 11, 2026 |
| Certified by provider | May 11, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor, Pediatric Chiropractor Primary | 111NP0017X | — | — |
| Chiropractor | 111N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OR) |
|---|
Other Chiropractor, Pediatric Chiropractor providers in Portland
- 1588147490
- 1013017664
- 1598680753
- 1972809770
- 1396088563
All Chiropractor, Pediatric Chiropractor providers in Oregon