| NPI | 1568608313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RODMAN Owner 503-538-7717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR D5827) |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2008-12-29 |