| NPI | 1992278030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL EMERY CFO 360-475-6710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-01-10 |