| NPI | 1942369772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES K COFFEE CEO 503-325-8315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2012-02-17 |