| NPI | 1477862142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE D CARRELLO Clinical Psychologist 503-516-9308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1626) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |