| NPI | 1851783534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVETTE LEWIS Practice Manager 503-421-5124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 174400000X Specialist (Licence: MA 254411) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2024-08-21 |