| NPI | 1366982258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON K SABINS Assistant Clinic Manager 503-635-1350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR DO14260) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2020-11-03 |