| NPI | 1710427810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY MARIE SCHAUB Clinical Services Manager 971-206-5179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2020-05-12 |