| NPI | 1023306149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POLLYANN LYSEN-HALPERN Owner 206-414-9992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA AP30003688) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2011-07-11 |