| NPI | 1205944204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY M LAWSHE Executive Program Director/Sponsor 503-391-9762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR OR10-036M) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |