| NPI | 1164586210 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DENNIS RICHARD NEAL Clinical Director 360-943-8810  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional | 
| 251S00000X Community/Behavioral Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2006-12-21 | 
| Last Update Date | 2021-03-03 |