| NPI | 1619864626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANNE SHEALY President 541-646-4088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QE0002X Clinic/Center, Emergency Care |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2026-05-01 |