Individual
DR. LEONORA BALBUENA DANTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 331-6440
Mailing address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 636-0763
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
ORMD0277
OR
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
WAMD00034628
WA
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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