| NPI | 1336434703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONNA ELIZABETH HONGO Sole Proprietor 503-235-4564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR 5984) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2011-06-14 |