| NPI | 1619285293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE NANI Owner/President 503-850-6935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OR DO175986) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: OR DO175986) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20A8801) | |
| 208D00000X General Practice (Licence: OR DO175986) | |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2022-07-21 |