| NPI | 1134205198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNA GREENE COO 503-249-8851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 208000000X Pediatrics | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-07-21 |