| NPI | 1659638872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT TYSON SCOTT Owner 503-370-8784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: OR DP154513) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2020-09-17 |