| NPI | 1740169028 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | NICOLE PAULY Payor Relationship Manager 425-640-7009  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Enumeration Date | 2025-08-29 | 
| Last Update Date | 2025-08-29 |