| NPI | 1689776916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA RAE YEAGER Addiction Medicine Therapist 360-636-6294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA CP00002701) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2020-08-22 |