| NPI | 1134405814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN R ERICKSON Physician 503-313-9020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR 13119) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |