| NPI | 1427823863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZY VENZKE Senior Billing Manager 503-205-4362 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2023-11-15 |