| NPI | 1144319658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WHITBECK Administrator 503-659-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-06-03 |