| NPI | 1043080807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA GAVRISHOVA Owner/Practitioner 360-559-1468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-01-03 |
| Last Update Date | 2024-01-03 |