| NPI | 1982272266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA JEANETTE SMITH Gen PT R 360-900-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2023-02-27 |