| NPI | 1629647367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA SHEPEL Contracting & Credentialing Manager 425-214-9321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-09-13 |