| NPI | 1588297063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POLLY GRAVELY Professional Counselor 503-310-7472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2021-06-08 |