| NPI | 1548960495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER PERELGUT Manager 971-419-3195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2023-03-17 |