| NPI | 1215024377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE EMANUEL ANDERSON Owner 503-827-0298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD22975) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |