| NPI | 1184185514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI JOYCE Chief Executive Officer 360-676-6177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2020-09-30 |