| NPI | 1457497497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL WOODLAND Credentialing Specialist 253-681-6601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: WA 6005372781) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2019-11-04 |