| 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 |