| NPI | 1891298303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE DIANE PENNINGTON Owner 503-744-7766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2018-03-10 |
| Last Update Date | 2018-03-10 |