| NPI | 1609016096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK MOTEN Interim Business Services Director 503-988-2966 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2024-05-18 |