| NPI | 1164455606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J OGLE Medical Director 503-261-0966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD20318) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |