| NPI | 1316533979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREN MALLORY Owner 503-303-4257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2020-12-17 |