| NPI | 1952860066 |
|---|---|
| Doing Business As | VISIONARY PSYCHIATRY |
| Entity Type | Organization |
| Authorized Contact | CARMEN L KOSICEK Owner, Provider 503-755-6703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2024-08-01 |