| NPI | 1235666272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE B DAHL Owner/Nurse Practitioner 541-500-0561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: OR 201500076NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-02-14 |