| NPI | 1053782078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM WATKINS Credentialing & Contracting Special 360-619-2226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2024-12-13 |