| NPI | 1477116358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME CHRISTINE LONG A RN P 253-227-1803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2020-07-23 |