| NPI | 1528643517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON RYAN Owner 541-727-7787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2023-05-04 |