| NPI | 1407070188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL DEAN JORGENSON Administrative Director 509-783-8833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 03-0444-00) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2008-06-12 |