| NPI | 1265908289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY BOUSCHOR Administrator 503-612-0498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |