| NPI | 1679508212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY HEITSCH Clinic Director 503-257-3327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OR MD11610) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-01-22 |