| NPI | 1295918910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WILFORD KELBER Owner/President 503-391-6615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR 10647) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2007-12-17 |