NPI | 1184824203 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES COFFEE CEO 360-636-3892 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2007-07-18 |
Last Update Date | 2022-05-31 |