| NPI | 1609525997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFFER JANOWIECKI Owner/Provider 360-488-8201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2025-04-15 |