| NPI | 1548721871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL LYNNE COOKE Sole Mbr 503-847-5473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-08-02 |