| NPI | 1235778812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE YAZZIE Credentialing 206-324-9360 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2022-09-15 |