| NPI | 1164632279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD B. BOLTON Director 503-370-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR L0191) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |