| NPI | 1780756080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN POTTER Billing Manager 206-323-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA 0169-00) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2024-05-07 |