| 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 |