| NPI | 1255682332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA TZENG Executive Director 503-974-6313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |