| NPI | 1407383730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN MARIE PETERS Owner/Physician 503-341-4563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 1401) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-07-21 |