| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1306509765 | ANDERSON | CHRISTINA | HEIDI | 1027 E BURNSIDE ST | PORTLAND | OR | 972141328 | |
| 1841473907 | GELARDO | GARY | ALLEN | 1027 E BURNSIDE ST | PORTLAND | OR | 972141328 | |
| 1629429345 | NEUBIG | HEIDI | 1027 E BURNSIDE ST | PORTLAND | OR | 972141328 | ||
| 1306339031 | RUNNELS | HEATHERLIN | J | 1027 E BURNSIDE ST | PORTLAND | OR | 972141328 | |
| 1366105595 | TENA | IRA | LEON | 1027 E BURNSIDE ST | PORTLAND | OR | 972141328 |