| NPI | 1508463639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL KELLY Physician Assistant, Owner 206-418-8222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2024-07-29 |