| NPI | 1730518754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA BERZOW Doctor 971-231-4372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 1871) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2015-02-24 |