| NPI | 1447692579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WINCHELL Physician 503-546-7663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 1941) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: OR AC161444) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2015-08-31 |