| NPI | 1831253673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BASTIAN WAGNER President 503-638-8218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD08471) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-10-09 |