| NPI | 1780796649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IONA LEANNE ROSE Claims Manager 541-883-2947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR 07-00000225) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |