| NPI | 1205146776 |
|---|---|
| Doing Business As | EVERGREEN BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | JILL B FANCHER Clinic Director/Owner 360-450-0140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 225700000X Massage Therapist | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2014-10-21 |