| NPI | 1831587856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH AYERS Credentialing Specialist 503-367-9089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2025-03-11 |