| NPI | 1972311041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA SOPHIA MARIE JONES Manager 503-523-0296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-12-20 |
| Last Update Date | 2024-12-20 |