| NPI | 1780320465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL EMERY CFO 360-475-6710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2022-05-10 |