BLUE HERON CLINIC PC
Ambulatory Health at Broadway St, Portland, OR

License number
Oregon 27-2971
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: DR. DANA SIBILLA DC
Title: DIRECTOR
Phone: (503) 280-9759
Address
Address
1934 NE Broadway St, Portland, OR 97232
National Provider ID: 1558529560
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about BLUE HERON CLINIC PC at bizstanding.com

BLUE HERON CLINIC, PC

1934 NE Broadway, Portland, OR 97232

Registration:
Jan 29, 2002
State ID:
6170997
Business type:
DOMESTIC BUSINESS CORPORATION
Agent:
James Whendry,1200 SW Main, Portland, OR 97205 (Physical)

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