| NPI | 1295582575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT LOUIS KOIVISTO Owner 503-522-2831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |