| NPI | 1275969602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA D CORTAL Owner 503-960-2162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 1917) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2013-09-17 |