| NPI | 1841575974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SELIS Psychotherapist 503-502-0208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L3485) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2011-10-20 |