| NPI | 1184086209 |
|---|---|
| Doing Business As | VIDA INTEGRATIVE MEDICINE & MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | TERI LITKE Administrator 503-399-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201402104-NP-PP) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 07-12-12) |
| 104100000X Social Worker (Licence: OR L6901) | |
| 106H00000X Marriage & Family Therapist (Licence: OR T0986) | |
| 106H00000X Marriage & Family Therapist (Licence: OR T0889) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2022-04-11 |