| NPI | 1659806032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY BLACKMOM-HUMPHREY Registered Nurse 206-207-9363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WC0400X Registered Nurse, Case Management (Licence: NJ 4219311) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60625891) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN60625891) | |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |