Organization
MY CHOICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE L SUSSMAN (EXECUTIVE DIRECTOR)
(360) 452-3300
Entity
Organization
Contact information
Practice address
824 E 8TH ST, PORT ANGELES, WA 98362-6451
(360) 452-3300
Mailing address
PO BOX 39, PORT ANGELES, WA 98362-0007
(360) 452-3300
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
601149379
WA
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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