| NPI | 1245635002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH HATCH Credentialing/Office Manager 541-606-4209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 1258) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 1258) |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OR 080046006) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2023-09-18 |