| NPI | 1528614674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLETTE F NGANTE Owner Of Entity 360-970-7708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2023-03-30 |