| NPI | 1649555145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINEVRA LOIS LIPTAN Medical Director 503-477-9616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: OR 28421) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2011-10-15 |