| NPI | 1134558976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE ERICKSON Co Owner 503-765-5265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 1976) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-12-05 |