| NPI | 1063525087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC SAMUEL DAVIS Director 503-370-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 279) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-07-21 |