| NPI | 1609639582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY M CARSON Registered Agent 503-975-7869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-02-02 |
| Last Update Date | 2024-02-02 |