| NPI | 1659535029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA PFAFFENBERGER Director 503-364-3022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: OR AC 01032) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OR AC 01032) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2011-04-22 |