| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1245784222 | TEEN CHALLENGE INTERNATIONAL PACIFIC NORTHWEST CENTERS | 6902 SE LAKE RD STE 300 | MILWAUKIE | OR | 972672148 | |||
| 1982131736 | GERIG | ROB | DEAN | 6902 SE LAKE RD STE 300 | PORTLAND | OR | 972672148 | |
| 1538516307 | NELSON | BRIAN | 6902 SE LAKE RD STE 300 | MILWAUKIE | OR | 972672148 |