| NPI | 1457788275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JEFFERSON DAWSON Cmo 509-222-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X Clinic/Center (Licence: WA MD00046152) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2024-06-26 |