| NPI | 1033493762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA NIBERT Manager 503-413-1600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR 200841070RN) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: WA RN60078715) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |