| NPI | 1942084215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LYNN CUMMINGS Principal 360-270-0105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2024-01-05 |