| NPI | 1689209371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARILYN CLAIRE ELLIS Psychologist/Owner 503-856-6430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-05 |