| NPI | 1649421587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY FENLASON Psychologist 425-275-2637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60090118) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2011-11-23 |