| NPI | 1588765523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTE KAPUALANI WATTS Geriatric Nurse Practitioner 503-237-0153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: OR 060018996N3anp/gnp) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-08-14 |