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 | 261QM2500X Clinic/Center, Medical Specialty |
261QM0850X Clinic/Center, Adult Mental Health | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2020-10-01 |
Last Update Date | 2025-10-02 |