| NPI | 1013141241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE PAYNE Business Services Manager 971-325-6412 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2026-08-28 |