| NPI | 1114292034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH M JOHNSON Owner 503-585-9695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR MD16845) |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2012-10-23 |