| NPI | 1811923147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M DENNING Practice Administrator 541-868-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR 174400000X) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-10-14 |