| NPI | 1548917289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI LYNN GRIMES Np C 253-244-3477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LC1500X Nurse Practitioner, Community Health | |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2023-09-26 |