| NPI | 1104031913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA JOHNSON Office Manager 503-224-9270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |