| NPI | 1134862543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARDOSA MOALLIN President 206-458-0728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |