| NPI | 1538298336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY NICOL Practice Manager 503-288-5201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR MD17937) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2010-07-08 |