| NPI | 1801856737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WHITBECK Administrator 503-659-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 207QS0010X Family Medicine, Sports Medicine | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-06-03 |