| NPI | 1457458721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA J BROUSSARD Office Manager 253-473-1844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CP00000521) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |