| NPI | 1679790604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK THOMAS O'HOLLAREN Owner 503-228-0155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: OR 13450) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |