| NPI | 1902927478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON BAST GAVORA President 503-636-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA TE00003919) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OR 1373) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-03-07 |