| NPI | 1952754038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY HACOPIAN Clinical Psychologist 503-928-6624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: OR 2430) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |