| NPI | 1295156818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRYLYNN TENNANT Owner 503-907-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: OR 6534) |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2013-12-27 |