| NPI | 1770357477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC WOOTEN Member/Manager 503-560-0175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-13 |