| NPI | 1417278011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE D FATHEREE Revenue /Credentialing Specialist 503-688-5187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2022-10-18 |