| NPI | 1225571706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN WAYNE HAWKINS Clinical Director 503-706-6426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR C2114) |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2016-12-01 |