| NPI | 1548330715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA BUNKER Owner 503-460-0405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: OR 227362) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2011-09-30 |