| NPI | 1770107187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN DAVIS Sole Member 503-495-3870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-06-01 |