Organization
SALLY GREEN DC LAC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALLY GREEN DC (OWNER)
(503) 236-9609
Entity
Organization
Contact information
Practice address
923 NE COUCH ST, PORTLAND, OR 97232-2926
(503) 236-9609
(503) 236-9609
Mailing address
923 NE COUCH ST, PORTLAND, OR 97232-2926
(503) 236-9609
(503) 236-9609
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27-1666
OR
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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