| NPI | 1255820239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN SANFORD FITZGERALD Nurse Practitioner 971-612-1588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 2015011081) |
| Enumeration Date | 2018-05-06 |
| Last Update Date | 2018-05-06 |