| NPI | 1700127941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY ROYCE PENDERGRAFT President 503-327-8713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 2227) |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other, EEG |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2013-03-13 |