| NPI | 1720483480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEHRI DAMAVANDI MOORE Medical Director 206-930-2616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2023-09-28 |