| NPI | 1477439644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE PETRIDGE Advocate/Admin Assistant 541-881-0153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 208000000X Pediatrics | |
| 2080C0008X Pediatrics, Child Abuse Pediatrics | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-08-28 |