| NPI | 1295119089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN HENDRICKSON Owner 503-709-3295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 2608) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |