| NPI | 1053541938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN BRIDGET MCDONOUGH Owner 503-485-0830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 2948) |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2009-07-25 |