| NPI | 1841000957 |
|---|---|
| Doing Business As | HOLLY WIGMORE |
| Entity Type | Organization |
| Authorized Contact | HOLLY WIGMORE Practice Owner 503-843-8862 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-01-10 |
| Last Update Date | 2025-01-10 |