| NPI | 1023324142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM RENO Billing/Credentialing Manager 425-868-2921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00013258) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-08-26 |