| NPI | 1689266926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ELIASON President 971-239-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| 208D00000X General Practice | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2026-04-03 |