| NPI | 1316785207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE ROSS Chief Financial Officer 360-296-7125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-12-26 |