| NPI | 1740715622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA DAVIS Owner 509-992-4224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60654992) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2019-03-19 |