| NPI | 1255845939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY DALE POOT Co Owner 360-421-2520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30006966) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA LH00005703) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2023-01-20 |