NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1538690664 |   |   |   | SHELLMIRE UNLIMITED | 5257 NE MLK JR BLVD | PORTLAND | OR | 972113282 |
1689103897 | BULTER | WALTER |   |   | 5257 NE MARTIN LUTHER KING JR BLVD STE 202 | PORTLAND | OR | 972113283 |
1801339734 | HENDERSON | NECOLA |   |   | 3311 NE MARTIN LUTHER KING JR BLVD | PORTLAND | OR | 972122086 |
1376085886 | KENT | KIMILIA | JENAE |   | 5257 NE MARTIN LUTHER KING JR BLVD | PORTLAND | OR | 972113282 |
1851833966 | NELSON | JASON |   |   | 5257 NE MARTIN LUTHER KING JR | PORTLAND | OR | 972113282 |
1508396706 | THOMAS | RONALD |   |   | 5257 NE MARTIN LUTHER KING JR BLVD STE 202 | PORTLAND | OR | 972113283 |