| NPI | 1528505401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ZAUROV Owner 971-599-3411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201700161NP-PP) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: OR 201700161NP-PP) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 201700160RN) | |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-02-09 |