| NPI | 1376768572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA RAYNE ANDERSON Owner 503-819-9726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 200250170NP FNP PP) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-31 |