| NPI | 1952609133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA ALQUIST Billing Specialist 425-485-6541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 600630032) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2023-08-30 |