| NPI | 1821388687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI LYN GABRIEL Owner/ Health Care Provider 503-492-3910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 29961) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |