| NPI | 1922555424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL I BERGMAN Sole Member 503-887-4137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 60446978) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2024-02-26 |