| NPI | 1548315583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY L SHIPMAN Administrator 360-385-3866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 601 852 847) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |