Organization
CHIROPRACTIC PHYSICIANS AND REHABILITATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA E STUART DC (OWNER)
(503) 252-3560
Entity
Organization
Contact information
Practice address
11657 NE GLISAN ST, PORTLAND, OR 97220-2264
(503) 252-3560
(503) 252-3199
Mailing address
11657 NE GLISAN ST, PORTLAND, OR 97220-2264
(503) 252-3560
(503) 252-3199
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3420
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3420
ACTIVE CHIROPRACTIC LICENSE
OR
Enumeration date
08/10/2017
Last updated
07/21/2022
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