| NPI | 1558571687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER K VAN PATTEN Doctor 503-472-8162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OR MD024130) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |