| NPI | 1649407644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W AGNOR Executive Director 360-253-4912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY00001983) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |