| NPI | 1386980340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN CELESTE DEWITT Owner/Operator 971-212-2553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR 1873) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2012-12-19 |