| NPI | 1750746004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY LYNNE BORMAN Owner/Physician 503-548-4008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR DO19719) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |