| NPI | 1033647201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTELLE BALDWIN Board Member 503-400-9397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 00217) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-07-21 |