| NPI | 1003992090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SON T DO Owner 360-576-5060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA md00042129) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2009-11-09 |