| NPI | 1174891782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA KATHLEEN RUTTO Pmhnp 503-288-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OR 200550034NP) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OR 200550034NP) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2011-12-09 |