| NPI | 1023207677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER S WEILAND Office Manager 509-758-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 15988) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2009-12-11 |