| NPI | 1487990180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY W BLISS Member 206-329-5255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30007542) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2012-12-27 |