| NPI | 1790280634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLEE SCHLIMGEN Clinic Manager 503-657-7629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD18335) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |