| NPI | 1568961969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S MAXWELL CEO 360-452-7891 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2023-11-15 |