| NPI | 1801305297 |
|---|---|
| Former Legal Business Name | MICHELLE MONG RYAN |
| Entity Type | Organization |
| Authorized Contact | MICHELLE MONG Owner 253-347-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA LF00001859) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2017-09-28 |