| NPI | 1376963652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BANJO WEYMOUTH Clinical Psychologist 503-577-2842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2135) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-04-24 |