| NPI | 1801968086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE J BEEBLE Administrator 503-491-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: OR 12-00004737) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2012-01-26 |