| NPI | 1376995175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS D GRAY Administrator 503-434-8285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: OR 200040842RN) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2022-09-12 |