| NPI | 1841073459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCISCA NEBE Manager 360-322-4665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-08-16 |