| NPI | 1316693591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK ELLIOT WHETSTONE Owner 503-554-0334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2022-02-25 |