| NPI | 1437418175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN CLARK Executive Director 360-330-9595 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2016-03-31 |