| NPI | 1962157628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTE MICHELLE PETIBONE Member/Manager/Clinician 503-443-6902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QB0400X Clinic/Center, Birthing |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2022-02-21 |