| NPI | 1386983922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE M DOUGLASS Owner 503-502-3989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: OR MD22100) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |