| NPI | 1306481981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN R KOSIK Owner 503-470-9844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 177F00000X Lodging |
| 251B00000X Case Management | |
| 261Q00000X Clinic/Center | |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2026-03-29 |