| NPI | 1942747761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH AYERS Credentialing Specialist 503-367-9089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2025-03-11 |