| NPI | 1588862643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA FAYE JAMES Counselor 503-933-2837 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OR 5536) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: OR 5536) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2007-07-10 |