| NPI | 1225760465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANA DE BURGO Speech Language Pathologist 360-393-6322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |