| NPI | 1912146911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JEAN MCGILL Manager 503-338-9423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200850049NP) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2009-02-13 |