| NPI | 1043488166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA CHRISTIE MCCORMACK Physician/Owner 503-616-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 465592-90) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-11 |