| NPI | 1982991139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA IDA DEHEN Cmo And Dean Of Clinics 503-552-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2015-11-25 |