| NPI | 1871862532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA RAVENSBERG Manager, Licensed Psychologist 503-536-3855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1740) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2011-12-23 |