| NPI | 1972192896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIE BOARDMAN Owner 503-307-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-01-14 |