| NPI | 1417335407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELLA PARKER Owner 503-252-3952 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR 1824) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |