| NPI | 1518454727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORTNEY ROUSE Credentialing/Billing Specialist 503-860-8913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 171100000X Acupuncturist |
| 225700000X Massage Therapist | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-04-13 |