| NPI | 1235454455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGDALENA JANINA BANASIAK Owner 503-990-6398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR MD 150631) |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2012-11-20 |