| NPI | 1669805388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA L SULLIVAN Clinic Manager 503-788-6483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: OR 952793-95) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care (Licence: OR 952793-95) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2013-08-16 |