| NPI | 1710763123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL ANN CARTER Clinical Director 360-601-8552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2025-05-01 |