| NPI | 1174917603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY HOWARD Office Manager 503-230-9224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 166613) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-23 |