| NPI | 1922139534 |
|---|---|
| Doing Business As | PORTLAND AVENUE FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | POLY LENG Manager 253-476-9121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-03-05 |