| NPI | 1366529638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAND WILLIAM BENNETTS Medical Director 503-229-7137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OR 07 1539) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |