| NPI | 1255831442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI LEWIS Billing Manager 360-441-9515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: WA LH60563533) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2018-02-14 |