| NPI | 1467480053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WALLACE TILSON Owner/President 503-408-8378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-08-22 |