| NPI | 1225306053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONNIE ISAACSON Nutrition Specialist 503-240-4055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WA D1 00000263) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |