| NPI | 1356172555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE M PETERSON Nurse Practitioner 503-805-4888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-09 |