| NPI | 1982654182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL P EMERY CFO 360-475-6710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 251E00000X Home Health | |
| 363L00000X Nurse Practitioner | |
| 101Y00000X Counselor | |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 122300000X Dentist | |
| 124Q00000X Dental Hygienist | |
| 133N00000X Nutritionist | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-04-10 |