| NPI | 1295432235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HICKS CEO 971-403-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QP2300X Clinic/Center, Primary Care | |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-03-07 |