| NPI | 1689557290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI TONE Corporate Controller 971-206-5125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-07-30 |