| NPI | 1750571345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB NIKKEL Executive Director 541-955-9565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OR 119488) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2010-08-11 |