NPI | 1912241746 |
---|---|
Entity Type | Organization |
Authorized Contact | MAUREEN ELLEN MAYS Sole Member 503-292-5678 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR MD25708) |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR MD25708) |
Enumeration Date | 2012-11-16 |
Last Update Date | 2023-03-07 |