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Organization

OPEN SKY NATURAL MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIDHRA JACKIW LAC (OWNER)
(971) 350-8508
Entity
Organization

Contact information

Practice address
1623 SE 6TH AVE, STE. 200, PORTLAND, OR 97214-3502
(971) 350-8508
(971) 275-1552
Mailing address
1623 SE 6TH AVE, STE. 200, PORTLAND, OR 97214-3502
(971) 350-8508
(971) 275-1552

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500773023
OR
Enumeration date
09/27/2023
Last updated
03/18/2024
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