| NPI | 1659891455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK L WELLER Owner 503-669-0453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD17310) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-21 |