OrganizationActive
Youth Villages
NPI 1992243992 · Adolescent and Children Mental Health Clinic/Center · Lake Oswego, OR
Provider details
- NPI number
- 1992243992
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Daina Tague, Er Diversion Specialist(541) 513-4998
- License
- M6979 (OR)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2507 Christie Dr
Lake Oswego, OR 97034
Phone: (503) 635-3416
Approximate (ZIP-level) locationGet directions
Mailing address
12945 Sw Hawks Beard St
Tigard, OR 97223-1956
Registry dates
- Enumerated
- 2017-02-09
- Last updated
- 2017-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.