| NPI | 1396014064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAVEL FOKSHA President 503-772-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OR 653593) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2011-12-23 |