| NPI | 1942607890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER KIRK JOHNSON Clinic Director 360-694-2016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY 00000813) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2014-11-20 |