| NPI | 1093980070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BROOKE Clinical Psychologist 503-481-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY00003704) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY00003079) |
| 103TC0700X Psychologist, Clinical (Licence: OR 1623) | |
| 103TC0700X Psychologist, Clinical (Licence: OR 1830) | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-08-18 |