| NPI | 1285414425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY DAWN MOORE Reginal Contracting Director 971-430-2335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2023-12-04 |