| NPI | 1407854243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI LEANNE HOVENDEN Office Manager 503-362-1314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR 13749) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2020-10-21 |