| NPI | 1316236847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIBRAN KEKOA RAMOS Owner 503-482-9092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OR 63999099) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2025-05-23 |