| NPI | 1639812589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL EMERY CFO 360-377-3776 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 103T00000X Psychologist |
| 101Y00000X Counselor | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 133N00000X Nutritionist | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-04-19 |