| NPI | 1376794008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLEEN HAVERTY Owner 503-278-3385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR 1676) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2011-05-06 |