Provider Demographics
NPI:1396597738
Name:COLIBRI CHIRORPRACTIC CLINIC
Entity type:Organization
Organization Name:COLIBRI CHIRORPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTI
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-953-5008
Mailing Address - Street 1:11830 KERR PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1226
Mailing Address - Country:US
Mailing Address - Phone:503-964-4212
Mailing Address - Fax:503-926-9142
Practice Address - Street 1:11830 KERR PKWY STE 300
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-1226
Practice Address - Country:US
Practice Address - Phone:503-964-4212
Practice Address - Fax:503-926-9142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty