| NPI | 1710489059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI LEWIS Billing Manager 360-441-9515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WA PY60723665) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2018-03-02 |