Individual
DR. BENJAMIN JAMES HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
524 SE 14TH AVE, PORTLAND, OR 97214-2428
(971) 544-7058
Mailing address
524 SE 14TH AVE, PORTLAND, OR 97214-2428
(971) 544-7058
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
33582
CA
111N00000X
Chiropractor
Primary
5922
OR
Other
Enumeration date
06/10/2016
Last updated
06/04/2021
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