| NPI | 1922490739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY GROW Owner 971-409-4412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: OR 14507) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2015-03-03 |