| NPI | 1932871985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY PAYNE Owner 503-756-5317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2021-10-21 |