| NPI | 1760129829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNAMARIE HARRISON Administrative Assistant 503-386-1972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2022-05-18 |