| NPI | 1831129733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERT KAE-JE' Director 509-582-3766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY00002470) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY00002470) |
| 103TC1900X Psychologist, Counseling (Licence: WA PY00002470) | |
| 163W00000X Registered Nurse (Licence: WA RN00152836) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |