| NPI | 1912376534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS PENG Md/Owner 503-407-8286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: OR 207QA0401X) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2015-09-24 |