| NPI | 1235307331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HUEBERT Owner 503-885-8008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: OR 23362) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2009-07-15 |