| NPI | 1093487415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAVANNAH LYN PLACE Patient Care Coordinator 360-560-2978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2021-10-04 |