| NPI | 1447476346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN PLAJA Fiscal Manager 360-786-5504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |