| NPI | 1538599055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARK WEBSTER RYAN Owner 503-287-4975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OR L2683) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2024-02-21 |