| NPI | 1922498914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER VLIET Owner 503-869-4071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OR C2470) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |