| NPI | 1881974772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE BISSETT Credentialing 503-467-7060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD13922) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OR MD13922) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2017-06-26 |