| NPI | 1659822401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ANN FULLER Sole Member 360-920-6843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF00000871) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |