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Organization
HEALTHBRIDGE INC
Active
Organization
HEALTHBRIDGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT B KELLUM N.D., L.AC. (PRESIDENT)
(503) 331-7393
Entity
Organization
Contact information
Practice address
3046 NE 33RD AVE, PORTLAND, OR 97212-3654
(503) 331-7393
Mailing address
3046 NE 33RD AVE, PORTLAND, OR 97212-3654
(503) 331-7393
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC00840
OR
175F00000X
Naturopath
Primary
1385
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1385
NATUROPATHIC LICENSE
OR
01
—
7277
MASSAGE LICENSE
OR
01
—
AC00840
ACUPUNCTURE LICENSE
OR
Enumeration date
12/14/2006
Last updated
04/11/2012
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