| NPI | 1568851459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN ELIZABETH MENGEDOHT Clinical Social Worker 503-468-8646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L6223) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |