| NPI | 1790006427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUISE TOLZMANN Owner 503-929-1910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: OR 0896) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2010-06-16 |