| NPI | 1740033430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER WILLIAM HOLST Owner 503-931-7902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-06-02 |