| NPI | 1538565015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA ANDERSON Physician 541-760-9644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR DO159457) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2014-11-11 |