| NPI | 1760430532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE ROSS Chief Financial & Compliance Office 360-676-6177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 251S00000X Community/Behavioral Health (Licence: WA 602160891 000UBI) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-06-15 |