| NPI | 1669977898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM STEWART Credentialing Mgr 503-662-6403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 61980) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-05-09 |