| NPI | 1609177518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE LYNN JOHNSON Owner 503-436-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: OR AC01225) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |