| NPI | 1346550936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN N RAITIERE Sole Provider/President 503-292-4538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR 16244) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2010-10-15 |