| NPI | 1942502794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL RIGGS Managing Member 503-582-8283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2021-09-01 |