| NPI | 1114752086 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | ROYLYNN UNDERWOOD Pmhnp 503-819-1064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-10-28 |