| NPI | 1760519060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY A SISK Executive Director 360-457-0431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-03-17 |