| NPI | 1578163317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISA GI8BSON Revenue Cycle Manager 360-475-6711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QA0005X Clinic/Center, Ambulatory Family Planning Facility | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD0000X Clinic/Center, Dental | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |