| NPI | 1831778620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT SPRAY Credentialing Manager 425-277-1311 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-04-07 |