| NPI | 1104333103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J GILBRIDE Director 503-367-3630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4036) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X (Licence: OR C4036) | |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2018-06-16 |