| NPI | 1821153941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON GRESH Clinic Operations Manager 503-224-1371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2021-05-21 |