| NPI | 1346899267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARY FARDAL President 503-837-3467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2020-01-06 |