| NPI | 1245026475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL DE LA MORA Owner 509-643-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-04-15 |