| NPI | 1154988681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL BRIANNA WOODLAND Credentialing Assistant 253-681-6601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-22 |