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1723 Kresky Ave Centralia WA 98531-8985 | |
| (509) 232-5766 | |
| (509) 321-5472 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1723 Kresky Ave, Centralia, Washington |
| Authorized Official Name and Position | Tiffany Dawn Stretch (CFO) |
| Authorized Official Contact | 5092325766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 141106 Spokane Valley WA 99214-1106 Ph: (509) 232-5766 | 1723 Kresky Ave Centralia WA 98531-8985 Ph: (509) 232-5766 |
| NPI Number | 1720578487 |
|---|---|
| Provider Enumeration Date | 05/17/2018 |
| Last Update Date | 05/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720578487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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