| NPI | 1043056500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L REARDON Medical Program Director 503-307-6834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |