| NPI | 1154702264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX JOSHUA LEWIS Human Resources Director 360-797-1752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2023-02-16 |