| NPI | 1023434271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN RAY MAROSTICA President 503-670-7088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR D9419) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-03-12 |