| NPI | 1669496204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JOSEPH WHITE Lead Pharmacist 503-988-3674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health (Licence: OR 100476) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-03-07 |