| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1104987635 | COST | GREGORY | A | 847 NE 19TH AVE | PORTLAND | OR | 972322684 | |
| 1083967020 | HWEE | WON | BAHNG | 847 NE 19TH AVE | PORTLAND | OR | 972322684 | |
| 1568650828 | MAUER | KRISTIN | KATHLEEN | 847 NE 19TH AVE | PORTLAND | OR | 972322684 |