| NPI | 1982630216 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DANIEL SCOTT GLANTZ Secretary/Treasurer 503-338-3803 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD20763) | 
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MD20748) | 
| Enumeration Date | 2006-06-26 | 
| Last Update Date | 2008-02-18 |