| NPI | 1225390495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA SEARLES Owner 503-222-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR ANP 083040868N3) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OR LAc AC00866) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |