| NPI | 1679703458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBIKA KAPHLE Qualified Mental Health Associate 503-418-5063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR 01301974) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |