| NPI | 1942433552 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DAVID JEFFREY OGLE President 503-663-3075 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR MD20318) | 
| Enumeration Date | 2009-08-29 | 
| Last Update Date | 2010-07-21 |