| NPI | 1891724506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES K COFFEE CEO 360-353-5803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-05-24 |