| NPI | 1609026582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANN CARNESE Owner 503-241-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: OR 12504) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2008-09-26 |