| NPI | 1952516643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA J BERNER Executive Director 360-671-3660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA 601309353) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |