| NPI | 1649882549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEDRA MARIE PINE Owner/Occupational Therapist 503-997-1309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2022-06-02 |