| NPI | 1598201568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN POTTER Billing Manager 206-323-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: WA 601-141-702) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2023-10-04 |