| NPI | 1568408680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIC KRISCIUNAS Lead Physician 503-626-0939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2010-07-27 |