| NPI | 1124133079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH K WICKENHAGEN President 503-439-1539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200550075NP) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |