| NPI | 1750668398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA CAROL HEROLD President 503-320-5001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2011-11-10 |