| NPI | 1548667918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK BERNTSEN Owner 503-956-9773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: OR BAP-TA-10133461) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |