| NPI | 1659429249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN ELLEN GRUBER President 541-201-3173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201050218) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201050217) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2015-08-11 |