| NPI | 1912521998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY WISE Owner, Dnp, Pmhnp Bc 503-781-5814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2022-01-01 |