| NPI | 1558052563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY MEYERS Credentialing Specialist 509-454-4143 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2023-05-19 |