| NPI | 1255167326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE NANI Owner 971-294-9104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-16 |