| NPI | 1881077204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILLARY INGRID KIBGIS Owner 503-922-9895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: OR 1069622) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2017-10-27 |