| NPI | 1659821023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORRY A ANOTTA Provider 503-384-2392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 201250053NP) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2017-10-26 |