| NPI | 1982008025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LEAF Owner 503-848-9110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: OR MD22901) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2023-05-09 |