| NPI | 1538601737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA SIDONIA DOMNITEI Member 503-467-8763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD155672) |
| Enumeration Date | 2016-11-06 |
| Last Update Date | 2016-11-06 |