| NPI | 1053926154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVETTE LEWIS Practice Manager 503-421-5124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine |
| 207RC0200X Internal Medicine, Critical Care Medicine | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2024-08-21 |