NPI | 1053035105 |
---|---|
Entity Type | Organization |
Authorized Contact | MARISSA OHLSTROM Provider/Sole Owner 206-531-4548 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2022-10-03 |
Last Update Date | 2022-10-26 |