| NPI | 1730625740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIAVASH EFTEKHARI Sole Mbr 503-866-3780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |