| NPI | 1023291812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA KIESSER Claims Biller 360-457-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA OP00001549) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2007-12-14 |