| NPI | 1023520814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MAGRAW Sole Member 503-449-7631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: OR 19492) |
| Additional Taxonomies | 261Q00000X (Licence: CA 4194) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2020-10-03 |