| NPI | 1124481783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSAMA BANKESLY President 206-403-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: WA MD00045130) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |