| NPI | 1184013161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESSETTA L SMITH Billing/Office Mngr., Auth. Officia 425-740-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA LW00009392) |
| 101YP2500X Counselor Professional (Licence: WA LW00009392) | |
| 104100000X Social Worker (Licence: WA LW00009392) | |
| 1041C0700X Social Worker Clinical (Licence: WA LW00009392) | |
| 106H00000X Marriage & Family Therapist | |
| 163W00000X Registered Nurse (Licence: WA RN00059378) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WA AP30007518) | |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2021-09-15 |