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Organization
KRUSE PARK CHIROPRACTIC CLINIC LLC
Active
Organization
KRUSE PARK CHIROPRACTIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M GALLIGAN D.C. (OWNER)
(503) 635-1236
Entity
Organization
Contact information
Practice address
3990 COLLINS WAY, 201, LAKE OSWEGO, OR 97035-3459
(503) 635-1236
(503) 697-4741
Mailing address
3990 COLLINS WAY, 201, LAKE OSWEGO, OR 97035-3459
(503) 635-1236
(503) 697-4741
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1674
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R109099
MEDICARE PTAN
OR
Enumeration date
11/02/2011
Last updated
07/09/2012
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