| NPI | 1164600243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIGETTE KREVANKO Office/Billing Manager 503-352-3854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-01-31 |