| NPI | 1811404353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY DAWN MOORE Medical Billing Manager 503-535-3842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |