| NPI | 1275329054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN POTTER Billing Manager 206-323-0930 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-04-17 |