| NPI | 1881832095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON WIEBE Director Of Operations 541-230-1630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200950078NP) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L4404) |
| 101YM0800X Counselor, Mental Health (Licence: OR C2485) | |
| 101YM0800X Counselor, Mental Health (Licence: OR C2422) | |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2013-07-16 |