| NPI | 1619418647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIAZ LARSEN Mental Health & Addiction Therapist 503-804-1467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C2855) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 11-03-20) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-18 |