| NPI | 1790195238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SILKE LAUB Manger/Member 503-380-6897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD C16813) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OR 5560) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2018-05-03 |