| NPI | 1013464809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BLANCHARD MERRICK Owner 503-781-3403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR L6896) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-08 |