| NPI | 1255501698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH PAUL MELVIN President 503-203-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR MD24232) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2008-02-29 |