| NPI | 1699804088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN W. VORIS Owner 503-581-0657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: OR L478) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2012-12-19 |