| NPI | 1689963191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET PENNETTI Credentialing Coordinator 425-203-0469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA MC60197685) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2019-04-29 |