| NPI | 1033853783 |
|---|---|
| Doing Business As | NORTHWEST VITALITY GROUP |
| Entity Type | Organization |
| Authorized Contact | HOLLY ANNE FAY Owner/Provider/Cmo 503-757-8535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2022-04-27 |