| NPI | 1053701854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN A WELCH Director 360-296-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60344737) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60258150) |
| Enumeration Date | 2015-01-31 |
| Last Update Date | 2015-01-31 |