| NPI | 1588172076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYSSA BAYNE-KIM Owner 503-550-7642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NH 1992) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |