| NPI | 1972838647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM RENO Credentialing/Billing 425-868-2921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD00047571) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2009-10-13 |