| NPI | 1376068478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDI TJOSTOLVSON Patient Financial Coordinator 503-626-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D9074) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2017-08-09 |