| NPI | 1174023808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE WAYSON LOCHER Therapist 971-279-7484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OR R3805) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |