| NPI | 1366141517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN DEREMER DAWN MOORE Medical Director 971-358-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-02-27 |