| NPI | 1194380840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL BRIANNA WOODLAND Credentialing Assistant 253-681-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM0801X |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |