| NPI | 1821577933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI LEWIS Billing Manager 360-441-9515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60609307) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |