| NPI | 1992935878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY DEVEREUX Clinic Manager 541-844-1495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD24983) |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2025-10-08 |