| NPI | 1689727265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DEKLOTZ Owner 503-579-3214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR 3542358) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-08-25 |