| NPI | 1962761155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE KOSCELNIK Owner 253-590-6878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: WA MA000021913) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2012-05-09 |