| NPI | 1902185234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUZ MARTHA CALLUM Psychologist 503-430-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 891) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 1624) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 2212) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |