| NPI | 1679697247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secreatry For Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2025-07-04 |