| NPI | 1225207178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY M MADDEN Administrator 503-505-5937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OR MD08914) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD08914) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: OR MD08914) | |
| 207N00000X Dermatology (Licence: OR MD08916) | |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2015-07-28 |