| NPI | 1457723587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA VIRGINIA WHITMIRE Administrator,Psychotherapist 425-227-0447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: WA LH60528456) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |