| NPI | 1841040292 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | EMERALD LOUISE NELSON FLORES Clinic Administrator 971-277-0559 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | 
| Additional Taxonomies | 207Q00000X Family Medicine | 
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2024-03-26 | 
| Last Update Date | 2024-07-10 |