| NPI | 1447202668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN CAROL WIGSTROM Credentialing And Contracting Speci 503-485-4787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2022-10-14 |