| NPI | 1770975005 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | AMANDA DEE GUTHMUELLER Counselor 509-951-7471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WA lh60560862) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-05-18 |