| NPI | 1255468179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN D MILLER Owner 503-648-8210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR 18724) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: OR 18724) |
| 261QU0200X Clinic/Center, Urgent Care (Licence: OR 18724) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: OR 18724) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OR 18724) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-11-27 |