| NPI | 1275360083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE A BARRETT Owner 360-720-4374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2025-07-31 |