| NPI | 1770044968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDYL WATTS Owner 503-333-7649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2021-07-22 |