| NPI | 1619599545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY COX Owner/Operations 503-732-0273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-10-15 |