| NPI | 1851825566 |
|---|---|
| Former Legal Business Name | MODERN NOSE CLINIC |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS J SKARADA Medical Director 503-584-1174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR 23186) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2022-05-02 |