| NPI | 1912691510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JALANE DAWN CAROLAND Pmhnp Bc 360-955-1714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |