| NPI | 1063071645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAI KIERON RENE RUSSELL Clinical Social Worker 206-930-8970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2021-12-08 |