| NPI | 1144677808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH A RUE Member 360-271-2750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA LF 60099920) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |