| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1780737106 | BLACK | JOSEPH | L | 3181 SW SAM JACKSON PARK RD | PORTLAND | OR | 972393011 | |
| 1306140033 | GRIGSBY | KRISTIN | 3181 SW SAM JACKSON PARK RD | PORTLAND | OR | 972393011 | ||
| 1629086491 | OTTO | BETTRICIA | A | 3181 SW SAM JACKSON PARK RD | PORTLAND | OR | 97239 |