| NPI | 1942861000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JA-ANGEL DEWALT Revenue Cycle Manager 360-475-6711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 133N00000X Nutritionist | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 208000000X Pediatrics | |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2020-04-28 |