| NPI | 1134436637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY TYREE COO 541-229-3332 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR 71216890) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR 71216890) |
| 363A00000X Physician Assistant (Licence: OR 71216890) | |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2025-07-01 |