| NPI | 1922800671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN ELAINE JOHNSON Owner/Master Trainer 509-928-0454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Additional Taxonomies | 171400000X |
| 302R00000X Health Maintenance Organization | |
| 305S00000X Point of Service | |
| Enumeration Date | 2025-03-25 |
| Last Update Date | 2025-03-25 |