| NPI | 1609217082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY LYNN STEWART Owner 503-567-8589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR AC159844) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2024-12-08 |