| NPI | 1376812131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK R MCCLUNG Owner 206-728-5878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA MD0032789) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2013-03-29 |