| NPI | 1255824264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JALEEN LYNN KLINK Medical Director 971-998-9747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 201407547NP-PP) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2022-06-18 |