NPI | 1922635887 |
---|---|
Entity Type | Organization |
Authorized Contact | LOCKY KAMAU Owner Of Entity 253-433-0910 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2020-03-23 |
Last Update Date | 2025-08-25 |