| NPI | 1396431474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL OLTMAN Owner/Physician 503-914-8455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |