NPI | 1699045872 |
---|---|
Entity Type | Organization |
Authorized Contact | BLAIN WEST CFO 503-941-3033 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 1223G0001X Dentist General Practice |
124Q00000X Dental Hygienist | |
126800000X Dental Assistant | |
Enumeration Date | 2012-01-05 |
Last Update Date | 2019-11-25 |