| NPI | 1427474790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL SILVES Office Manager 360-627-9219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X (Licence: WA MD00033182) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30003880) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2015-03-16 |