| NPI | 1104348887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY STAUDENMIER Owner 503-974-0347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| 332BD1200X Durable Medical Equipment & Medical Supplies Dialysis Equipment & Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-07-21 |