| NPI | 1952053522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE P JENSRUD Billing And Credentialing Manager 541-766-6190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |