| NPI | 1982350203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA SHEPEL Contracting & Credentialing Manage 425-214-9321 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2022-02-24 |