| NPI | 1861939597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE HEIN Executive Director 360-515-0788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA 602957992) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |