| NPI | 1225351901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S PETERSON Owner 503-561-7227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD16135) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2011-03-08 |