| NPI | 1598038390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA SEARLES Owner 503-943-9842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR ANP 083040868N3) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OR LAC AC00866) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |