NPI | 1093244642 |
---|---|
Entity Type | Organization |
Authorized Contact | LESLIE JUNE CHRISTIANSEN Owner/Provider 503-679-6881 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: OR 8052) |
Additional Taxonomies | 302R00000X Health Maintenance Organization |
Enumeration Date | 2017-06-07 |
Last Update Date | 2022-07-21 |