Organization
BLUESTONE CLINIC LLC
Active
Other names
The Bluestone Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW FRIEDE (MANAGER)
(260) 577-2266
Entity
Organization
Contact information
Practice address
111 SW 5TH AVE, PORTLAND, OR 97204-3604
(260) 577-2266
Mailing address
800 NW POWHATAN TER, PORTLAND, OR 97210-2733
(260) 577-2266
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
Other
Enumeration date
05/11/2023
Last updated
08/30/2023
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