| NPI | 1235263583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY DEVASIER Clinical Director 360-696-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA LW00009293) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |