| NPI | 1588052393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY BRYCE FARMER President 503-451-3267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 5679) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2016-09-30 |