| NPI | 1801177902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MARIE MINER Licensed Psychologist 503-351-9432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OR 2131) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OR 2131) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-01 |