| NPI | 1124652821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA SANDERSON Owner 971-264-0879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-08-02 |