| NPI | 1285023382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE FAY NELSON Admin 503-512-5359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 1695) |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |