| NPI | 1013398148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM KILEY Co Owner 503-648-3125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |