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Organization
POPE'S KIDS PLACE
Active
Organization
POPE'S KIDS PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA DICKSON (EXECUTIVE DIRECTOR)
(360) 736-9178
Entity
Organization
Contact information
Practice address
230 WASHINGTON WAY, CENTRALIA, WA 98531-9325
(360) 736-9178
(360) 736-8312
Mailing address
230 WASHINGTON WAY, CENTRALIA, WA 98531-9225
(360) 736-9178
(360) 736-8312
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
—
NULL
2084P0015X
Psychosomatic Medicine Physician
—
—
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
05/10/2007
Last updated
11/21/2022
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