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Organization
HEART BRIDGE MEDICINAL ARTS LLC
Active
Organization
HEART BRIDGE MEDICINAL ARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI KRISTEN MIRACLE LAC, MS (OWNER)
(971) 808-9186
Entity
Organization
Contact information
Practice address
1734 NE BROADWAY ST, PORTLAND, OR 97232-2783
(971) 808-9186
Mailing address
3123 N WILLAMETTE BLVD APT 201, PORTLAND, OR 97217-4080
(971) 808-9186
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
06/19/2024
Last updated
09/11/2025
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