| NPI | 1770209439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY CHUPP Manager 503-490-5836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2024-08-21 |