| NPI | 1316241078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE N EBLING Partner 503-505-9677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: OR 3917) |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty (Licence: OR AC153123) |
| 261QM1300X Clinic/Center Multi-Specialty (Licence: OR 8058) | |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |