| NPI | 1306116694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER WILLIAM ANDERSON Owner 503-434-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR 2958) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |