Organization
LIBERTY BLANK, N.D., LLC
Active
Parent organization
LIBERTY BLANK, N.D., LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIBERTY BLANK, N.D., LLC
Authorized official
LIBERTY BLANK N.D. (OWNER)
(503) 944-1138
Entity
Organization
Contact information
Practice address
15160 NW LAIDLAW ROAD, SUITE 245, PORTLAND, OR 97229
(503) 944-1138
Mailing address
164 NW MACLEAY BLVD, PORTLAND, OR 97210
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
10/24/2025
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