| NPI | 1366638843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY PATRICK CONNALL Medical Director 503-783-0542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-09-19 |