| NPI | 1659721397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINN REY MENZIE Bhs Program Manager 503-280-6646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR L4861) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |