| NPI | 1932204039 |
|---|---|
| Doing Business As | PMG/47TH AVENUE |
| Entity Type | Organization |
| Authorized Contact | MITCHELL NEYHART Chief Financial Officer 503-574-9840 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2010-04-16 |