| NPI | 1306394549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK MOTEN Interim Business Services Director 503-988-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: OR 201606068NP-PP) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2024-05-18 |