| NPI | 1376024695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEREK KANSO Therapist 503-866-9688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR c4721) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-08-24 |