| NPI | 1962799353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA GRACE WOOD Owner 503-515-8183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: OR 1551) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-07-06 |