| NPI | 1154107027 |
|---|---|
| Former Legal Business Name | ADVENTURE PSYCHOTHERAPY |
| Entity Type | Organization |
| Authorized Contact | MARK GASKILL CEO 360-582-6032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2024-03-20 |