| NPI | 1770365413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISTA KILDOW System Admin 503-374-3730 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2023-10-17 |