| NPI | 1184354524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE ANDERSON Senior Director Provider Enrollment 503-910-6182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2024-11-20 |