| NPI | 1902100902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN STEWART PREISS Owner 503-291-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 2711) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |