South Correctional Entity

NPI #1851198212 in Des Moines, Washington

Provider Information

NPI Number
1851198212
Entity Type
Organization
Organization Name
South Correctional Entity
Primary Specialty
Clinic/Center - Prison Health
Enumeration Date
Feb 25, 2025
Last Updated
Feb 25, 2025

Practice Location

Address
20817 17TH AVE S
ZIP Code
98198-7665
Phone
(206) 257-6200

Authorized Official

Name
DEVON SCHRUM
Title
EXECUTIVE DIRECTOR
Phone
(206) 257-6262

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Prison HealthPrison Health

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