| NPI | 1750127429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMOND DESHAWN WILLIAMS Clinical Supervisor 503-334-9955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-07-02 |