| NPI | 1104148741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN W CLARKE President 503-524-9656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2025-04-22 |