| NPI | 1225806359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL SOLOMON AGEZE Owner 425-344-3949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2024-05-21 |