| NPI | 1710748090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MCALPINE Credentialing Specialist 503-412-6436 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-01-23 |