| NPI | 1366595670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA IRENE ROTHWELL Office Manager 503-215-1755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR MD18373) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2008-12-03 |