| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1346467404 | BASSILI | TONY | 11982 NE GLISAN ST | PORTLAND | OR | 972202143 | ||
| 1952529661 | LACRAMPE | ETIENNE | 11982 NE GLISAN ST | PORTLAND | OR | 972202143 | ||
| 1528286242 | LUNT | ROGER | 11982 NE GLISAN ST | PORTLAND | OR | 972202143 |