| NPI | 1114297678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN Z MANGNALL-HARRIS Owner 541-289-0955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201150002NP) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |