| NPI | 1215420963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB JEREMY MARKOVITZ Owner/Operator 206-403-1374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60484101) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2023-11-30 |