| NPI | 1992571954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA JOY HAYNES Controller 503-542-2253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-11-30 |
| Last Update Date | 2024-04-18 |