| NPI | 1023200813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE BURTON MORTIMER Chairman And President 360-882-9058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00028371) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |