| NPI | 1255814331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER GOLD Owner 503-806-9680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |