| NPI | 1528066859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA COLBURN Practice Administrator 503-419-4940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR 2000742) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR 646412) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2020-10-22 |