| NPI | 1528828852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL C WARD Medical Director 971-500-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-08-15 |