| NPI | 1619420379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY CHARBONEAU Licensed Neuropsychologist 509-838-8066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: WA PY00002046) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |