| NPI | 1790472728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN ILI Owner 503-487-5954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2024-04-23 |