| NPI | 1992297121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MICHELE VAN DRIMMELEN Administrator 503-303-4257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1633) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-27 |