| NPI | 1427674324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR JORGENSEN Md/Owner 503-883-8297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-07-27 |