| NPI | 1265674022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY DENISON Owner/Member 503-647-7522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 163W00000X Registered Nurse |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |