| NPI | 1194079301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L SEVERNS Psychologist 253-888-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA PY00002989) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-27 |