| NPI | 1174892301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARA LYNN LURAS Prescriber Support Specialist 503-623-9289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR 201130510LPN) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |