| NPI | 1851810626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERALD WALKER President/CEO 503-238-0769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2017-09-13 |