| NPI | 1922567759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN OTTERSON Owner 360-631-0949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-06-23 |